Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Oct 31;20(1):530.
doi: 10.1186/s12935-020-01628-7.

Geriatric nutritional risk index as a predictor of complications and long-term outcomes in patients with gastrointestinal malignancy: a systematic review and meta-analysis

Hailun Xie  1 , Shuangyi Tang  2 , Lishuang Wei  3 , Jialiang Gan  4
Affiliations
Review

Geriatric nutritional risk index as a predictor of complications and long-term outcomes in patients with gastrointestinal malignancy: a systematic review and meta-analysis

Hailun Xie et al. Cancer Cell Int. .

Abstract

Background: The effect of the geriatric nutritional risk index (GNRI) on the prognosis of patients with gastrointestinal malignancy remains unclear. The aim of our study was to systematically explore the value of the GNRI in evaluating postoperative complications and long-term outcomes in gastrointestinal malignancy.

Methods: A systematic literature search was conducted using electronic databases to report the impact of the GNRI on postoperative complications and long-term outcomes of patients with gastrointestinal malignancies as of August 2020. The hazard ratio (HR) with a 95% confidence interval (CI) was used to evaluate the impact of the GNRI on long-term outcomes. The risk ratio (RR) with 95% CI was used to assess the impact of the GNRI on postoperative complications.

Result: A total of nine studies with 2,153 patients were enrolled in our meta-analysis. The results suggested that a low GNRI was correlated with poor overall survival of patients with gastrointestinal malignancy (HR = 1.94, 95% CI 1.65-2.28, p < 0.001). Patients with a low GNRI had a higher risk of complications than patients with a high GNRI (OR = 2.19, 95% CI 1.57-3.05, p < 0.001). In addition, patients with a low GNRI had shorter relapse-free survival (HR = 2.45, 95% CI 1.50-4.00, p < 0.001) and disease-free survival (HR = 1.84, 95% CI 1.23-2.76, p = 0.003) than those with a high GNRI. However, the GNRI was not an independent factor affecting cancer-specific survival (HR = 1.60, 95% CI 0.91-2.82, p = 0.101).

Conclusion: Based on existing evidence, the GNRI was a valuable predictor of complications and long-term outcomes in patients with gastrointestinal malignancy.

Keywords: Complications; Gastrointestinal malignancy; Geriatric nutritional risk index; Prognosis.

PubMed Disclaimer

Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

Fig. 1
Fig. 1
Flowchart of included studies
Fig. 2
Fig. 2
Forest plot for the association between GNRI and overall survival
Fig. 3
Fig. 3
Sensitivity analysis for the association between GNRI and overall survival
Fig. 4
Fig. 4
Plots for publication bias test in meta-analysis for overall survival. a Begg’s funnel plot; b Egger’s publication bias plot; c The trim-and-fill methods;
Fig. 5
Fig. 5
Forest plot for the association between GNRI and complications
Fig. 6
Fig. 6
Sensitivity analysis for the association between GNRI and complications
Fig. 7
Fig. 7
Plots for publication bias test in meta-analysis for complications. a Begg’s funnel plot; b Egger’s publication bias plot
Fig. 8
Fig. 8
Forest plot for the association between GNRI and relapse-free survival (a)/disease-free survival (b)/cancer-specific survival (c)
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):E359–E386. doi: 10.1002/ijc.29210. - DOI - PubMed
    1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin. 2016;66(1):7–30. doi: 10.3322/caac.21332. - DOI - PubMed
    1. Liu FT, Dong Q, Gao H, Zhu ZM. The prognostic significance of UCA1 for predicting clinical outcome in patients with digestive system malignancies. Oncotarget. 2017;8(25):40620–40632. doi: 10.18632/oncotarget.16534. - DOI - PMC - PubMed
    1. Nakamura Y, Yoshino T. Clinical utility of analyzing circulating tumor DNA in patients with metastatic colorectal cancer. Oncologist. 2018;23(11):1310–1318. doi: 10.1634/theoncologist.2017-0621. - DOI - PMC - PubMed
    1. Arends J, Baracos V, Bertz H, Bozzetti F, Calder P, Deutz N, et al. ESPEN expert group recommendations for action against cancer-related malnutrition. Clin Nutr. 2017;36(5):1187–1196. doi: 10.1016/j.clnu.2017.06.017. - DOI - PubMed

LinkOut - more resources