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; Takahiro Toyokawa; Takemi Ishidate; Kenji Kuroda; Yuichiro Miki; Mami Yoshii; Tatsuro Tamura; Shigeru Lee; Kiyoshi Maeda

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

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

Authors

Hironari Miyamoto¹, Takahiro Toyokawa², Takemi Ishidate³, Kenji Kuroda³, Yuichiro Miki³, Mami Yoshii³, Tatsuro Tamura³, Shigeru Lee³, Kiyoshi Maeda³

Affiliations

¹ Department of Gastroenterological Surgery, Minami Osaka Hospital, 1-18-18 Higashikagaya, Suminoe-ku, Osaka, 559-0012, Japan.
² Department of Gastroenterological Surgery, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan. t-toyokawa0120@omu.ac.jp.
³ Department of Gastroenterological Surgery, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan.

PMID: 39538153
DOI: 10.1186/s12885-024-13158-w

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.