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. 2024 Nov 13;24(1):1396.
doi: 10.1186/s12885-024-13158-w.

Significance of the geriatric nutritional risk index and neutrophil-to-lymphocyte ratio as prognostic indicators in older patients with gastric cancer: a retrospective cohort study

Hironari Miyamoto  1 , Takahiro Toyokawa  2 , Takemi Ishidate  3 , Kenji Kuroda  3 , Yuichiro Miki  3 , Mami Yoshii  3 , Tatsuro Tamura  3 , Shigeru Lee  3 , Kiyoshi Maeda  3
Affiliations

Significance of the geriatric nutritional risk index and neutrophil-to-lymphocyte ratio as prognostic indicators in older patients with gastric cancer: a retrospective cohort study

Hironari Miyamoto et al. BMC Cancer. .

Abstract

Background: The number of older patients with cancer is increasing with the progression of aging societies. In the current study, we sought to clarify the prognostic values of the geriatric nutritional risk index (GNRI) as a nutritional index and the neutrophil-to-lymphocyte ratio (NLR) as an inflammatory index in older patients with gastric cancer.

Methods: Between January 2007 and December 2016, a total of 197 consecutive gastric cancer patients aged ≥ 75 years who underwent radical gastrectomy were enrolled in this study. The prognostic values of preoperative GNRI and NLR were assessed using time-dependent receiver operating characteristic curve analysis, log-rank tests, and Cox regression analysis.

Results: The areas under the curve (AUCs) predicting 5-year overall survival (OS) were 0.668 for GNRI and 0.637 for NLR. The 5-year OS rates in the groups with low GNRI and NLR were 40.1% and 74.1% (p < 0.001), and those with high GNRI and NLR were 70.7% and 41.5% (p < 0.001), respectively. Multivariate analysis showed that GNRI (hazard ratio (HR): 0.584; 95% confidence interval (CI): 0.356-0.960; p = 0.034) and NLR (HR: 2.470; 95% CI: 1.503-4.059; p < 0.001) were independent predictors for OS. The GNRI-NLR score constructed with GNRI and NLR had a higher AUC (0.698) than those of GNRI or NLR alone and was an independent prognostic factor (HR, 0.486; 95% CI: 0.363-0.651; p < 0.001).

Conclusions: GNRI and NLR are useful prognostic biomarkers in older patients with gastric cancer aged ≥ 75 years. The GNRI-NLR score could contribute to a more personalized and holistic approach to cancer treatment in this patient population.

Keywords: Elderly patient; Gastric cancer; Inflammation; Nutrition.

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Conflict of interest statement

Declarations Ethics approval and consent to participate This retrospective study was approved by the Ethics Committee of Osaka Metropolitan University Graduate School of Medicine (approval no. 2023-013) and conducted in accordance with the principles of the Declaration of Helsinki. Due to the retrospective nature of the study, we used the opt-out approach to disclose the study information instead of written informed consent. We obtained an &quot; informed consent waiver&quot; from the Ethical Committee of Osaka Metropolitan University Graduate School of Medicine. Consent for publication Not applicable. Competing interests The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Time-dependent receiver operating characteristic curves of the (A) geriatric nutritional risk index (GNRI; black arrow indicates the optimal cut-off point) and (B) neutrophil–lymphocyte ratio (NLR; white arrow indicates the optimal cut-off point) predicting 5-year overall survival
Fig. 2
Fig. 2
Kaplan–Meier survival curves of overall survival according to the geriatric nutritional risk index (GNRI) (A) and neutrophil–lymphocyte ratio (NLR) (B) in older patients with gastric cancer
Fig. 3
Fig. 3
Kaplan–Meier survival curves of overall survival (OS) (A) and relapse-free survival (RFS) (B) according to the combined geriatric nutritional risk index (GNRI)/neutrophil–lymphocyte ratio (NLR) score in older patients with gastric cancer
See this image and copyright information in PMC

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