A new study suggests that the Geriatric Nutritional Risk Index (GNRI) may be a predictor of complications and overall prognosis following surgery for colorectal cancer (CRC). The study results were published in the journal Scientific Reports.

The GNRI allocates patients to nutrition-based risk groups using serum albumin level, height, current body weight, and ideal body weight, explained the researchers. For this study, they retrospectively studied 313 patients with CRC who were aged 65 years or older and who underwent curative surgery at the Osaka University Hospital in Osaka, Japan.

The researchers evaluated patient outcomes following surgery after stratifying patients according to GNRI, into either an all-risk group or a no-risk group. The all-risk group had GNRI scores of 98 or lower, with the no-risk group having GNRI scores higher than 98.

Patients in this analysis had a median age of 73 years (range, 65 to 94). Stage 0 disease was present in 9.3% of patients, with stage I disease in 36.7%, stage II disease in 24.6%, stage III disease in 26.5%, and stage IV disease in 2.9%. Prior to surgery, the mean GNRI was 98.2.


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The median study follow-up occurred at 60.5 months. The overall survival (OS) rate of patients in the all-risk group was significantly poorer than in the no-risk group (P =.009). The 5-year OS rates were 79.6% for the all-risk GNRI group and 86.0% for the no-risk group.

In multivariate analyses, low GNRI was an independent predictor for overall survival (P =.001) and a predictor of postoperative complications (P =.048).

“Preoperative GNRI can be a useful tool to identify high-risk population of morbidity and mortality in elderly patients with CRC,” the researchers concluded in their report.

Reference

Sasaki M, Miyoshi N, Fujino S, et al. The Geriatric Nutritional Risk Index predicts postoperative complications and prognosis in elderly patients with colorectal cancer after curative surgery. Sci Rep. 2020;10(1):10744. doi:10.1038/s41598-020-67285-y