Preoperative Geriatric Nutritional Risk Index: A predictive and prognostic factor in patients with pathological stage I non-small cell lung cancer. (December 2017)

• Record Type: Journal Article
• Authors: Shoji, Fumihiro; Matsubara, Taichi; Kozuma, Yuka; Haratake, Naoki; Akamine, Takaki; Takamori, Shinkichi; Katsura, Masakazu; Toyokawa, Gouji; Okamoto, Tatsuro; Maehara, Yoshihiko
• Is Part Of: Surgical oncology. Volume 26:Number 4(2017)
• Page Start: 483
• Page End: 488
• Publication Date: 2017-12
• Subjects: Non-small cell lung cancer -- Geriatric Nutritional Risk Index -- Predictive and prognostic factor; AUC area under the curve -- BVI blood vessel invasion -- CEA carcinoembryonic antigen -- CS cancer-specific survival -- CT computed tomography -- CYFRA cytokeratin 19 fragment -- FDG-PET fluorodeoxyglucose-positron emission tomography -- GNRI geriatric nutritional risk index -- LVI lymphatic vessel invasion -- MRI magnetic resonance imaging -- NCCN National Comprehensive Cancer Network -- NSCLC non-small-cell lung cancer -- OS overall survival -- RFS Recurrence-free survival -- ROC receiver operating characteristics -- RR relative risk -- UFT uracil-tegafur chemotherapy; Cancer -- Surgery -- Periodicals; Neoplasms -- surgery -- Periodicals; Cancer -- Chirurgie -- Périodiques; Electronic journals; 616.994059
• DOI: 10.1016/j.suronc.2017.09.006
• Languages: English
• ISSNs: 0960-7404

Abstract

Abstract: Background: Surgical outcomes of early-stage non-small cell lung cancer (NSCLC) are poor. The Geriatric Nutritional Risk Index (GNRI) is a useful parameter for evaluating nutritional status. We aimed to investigate if preoperative GNRI could be a predictive factor for pathological stage I NSCLC patients. Patients and methods: We retrospectively selected 141 consecutive pathological stage I NSCLC patients treated from August 2005 to August 2010. We analyzed their preoperative GNRI in univariate and multivariate Cox regression analyses for postoperative recurrence-free survival (RFS). Results: A preoperative abnormal GNRI was significantly associated with postoperative recurrence ( P = 0.0107). Univariate analyses showed that serum carcinoembryonic antigen (CEA) levels ( P = 0.0013), preoperative serum albumin level ( P < 0.0001), preoperative GNRI ( P = 0.0009), pleural invasion ( P < 0.0001) and blood vessel invasion ( P = 0.0137) significantly affected RFS. In multivariate analysis, preoperative GNRI ( P = 0.0084), CEA level ( P = 0.0031), preoperative serum albumin level ( P = 0.0041) and pleural invasion ( P = 0.0018) were independent prognostic factors. In Kaplan–Meier analysis of RFS, cancer-specific survival (CS), and overall survival (OS) by preoperative GNRI, the abnormal GNRI group had significantly shorter RFS, CS, and OS (5-year RFS, CS, and OS: 52.81% vs. 89.15%; P < 0.0001, 81.73% vs. 94.73%; P = 0.0014 and 50.84% vs. 89.57%; P < 0.0001, log-rank test, respectively). Conclusions: Preoperative GNRI is a novel prognostic factor for pathological stage I NSCLC patients, which can identify high-risk patients for postoperative recurrence and cancer-related death. Highlights: The GNRI is based on two parameters including serum albumin and body weight. We analyzed p-stage I NSCLC patients to investigate effects of preoperative GNRI. Preoperative GNRI was significantly associated with postoperative recurrence. Preoperative abnormal GNRI group had significantly shorter RFS, CS, and OS. Preoperative GNRI is a simple and novel prognostic factor.