Geriatric Nutritional Risk Index as Prognostic Marker for Elderly Patients With Small Cell Lung Cancer

Abstract

Background/aim: The Geriatric Nutritional Risk Index (GNRI) indicates nutritional status based on serum albumin concentration and ideal body weight. Pretreatment GNRI has been suggested as a prognostic factor for various malignancies. However, little is known about the clinical value of GNRI for small-cell lung cancer (SCLC), especially in elderly patients.

Patients and methods: We retrospectively analyzed 53 elderly (≥71) patients with extensive-disease (ED) SCLC treated with first-line platinum-doublet chemotherapy in relation to the pretreatment GNRI level in a real-world setting.

Results: Thirty-six patients with a low GNRI (<92) had statistically poorer progression-free survival (PFS) and overall survival (OS) than 17 patients with a high GNRI (≥92) (median PFS=80 days vs. 133 days, respectively; p=0.002; median OS=123 days vs. 274 days, respectively; p=0.004). In a multivariate analysis, a low GNRI was also an independent poor prognostic factor for PFS [hazard ratio (HR)=0.396; 95% confidence interval (CI)=0.199-0.789; p=0.008] and OS (HR=0.295; 95%CI=0.143-0.608; p<0.001).

Conclusion: The GNRI might be a predictive and prognostic marker in elderly patients with ED-SCLC treated with platinum-doublet chemotherapy.

Keywords: Geriatric Nutritional Risk Index; Small-cell lung cancer; prognostic marker.

Figure 1. Kaplan–Meier survival curves of progression-free (A) and overall (B) survival categorized according to the Geriatric Nutritional Risk Index (GNRI). The median progression-free survival (PFS) for patients with high and low serum GNRI levels was 133 days [95% confidence interval (CI)=110-157] and 80 days (95%CI=39-119), respectively (p=0.002). The median overall survival (OS) was 274 days (95%CI=193-434) and 123 days (95%CI=61-300), respectively (p=0.004).