Modified geriatric nutrition risk index as a prognostic predictor of esophageal cancer

Autor: Kazuo Hase, Yusuke Ishibashi, Hideki Ueno, Yoji Kishi, Keita Kouzu, Hidekazu Sugasawa, Hironori Tsujimoto
Rok vydání: 2020
Předmět:
Zdroj: Esophagus. 18:278-287
ISSN: 1612-9067
1612-9059
DOI: 10.1007/s10388-020-00795-w
Popis: This study aimed to establish a simple and useful prognostic indicator for elderly esophageal cancer patients. We designed the modified geriatric nutrition risk index (mGNRI) using the inverse of C-reactive protein (CRP) instead of albumin and compared its prognostic value with those of the GNRI and other indices.We included 128 patients aged 65 years who underwent esophagectomy for esophageal cancer. We defined mGNRI as (1.489/CRP in mg/dL) + (41.7 × present/ideal body weight) and divided patients into two groups: the low-mGNRI (mGNRI 70, n = 50) and high-mGNRI (mGNRI ≥ 70, n = 78) groups. We retrospectively examined the relationship between mGNRI and long-term prognosis.The low-mGNRI group had more advanced cancer by stage, higher rates of recurrence, and earlier recurrence than the high-mGNRI group. Univariate analysis identified the following factors as significantly associated with poor overall survival (OS): a lower American society of anesthesiologist performance status (ASA-PS), male gender, CRP-albumin ratio ≥ 0.1, CRP ≥ 1.0, low-mGNRI, tumor depth ≥ T3, Charlson comorbidity index ≥ 2, tumor size ≥ 40 mm, and age 75 years. A low-mGNRI, ASA-PS 3, age 75 years, and tumor depth ≥ T3 were independent unfavorable prognostic factors for OS. A low-mGNRI was an independent poor prognostic factor for relapse-free survival. We performed model selection analysis to identify the most clinically useful indices; mGNRI was the best predictive model.mGNRI in patients with esophageal cancer correlated with early recurrence and was a useful independent prognostic factor.
Databáze: OpenAIRE
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