Modified Geriatric Nutrition Risk Index as a Prognostic Predictor for Unresectable/Recurrent Esophageal Cancer

Abstract

Background/aim: This study aimed to evaluate the prognostic value of modified geriatric nutritional risk index (mGNRI) in patients with unresectable/recurrent esophageal cancer (EC).

Patients and methods: We included 143 patients aged >65 years with unresectable/recurrent EC. The mGNRI was calculated as (1.489/CRP in mg/dl) + (41.7 × body mass index/22). Participants were divided into two groups: low-mGNRI (mGNRI <80, n=90) and high-mGNRI (mGNRI ≥80, n=53). We retrospectively examined the relationship between mGNRI and the prognosis of EC.

Results: Median survival time in the low-mGNRI group was significantly lower than that in the high-mGNRI group (5.1 vs. 16.9 months, p<0.001). Multivariate analysis revealed that low mGNRI [hazard ratio (HR)=3.85, p<0.001] and absence of chemotherapy or chemoradiotherapy (HR=2.69, p<0.001) were independent and unfavorable prognostic factors of overall survival. Among patients who received chemotherapy or chemoradiotherapy, the mGNRI-low group had a significantly poorer prognosis than the mGNRI-high group (p<0.001). The mGNRI was the most appropriate prognostic index compared with other immune-inflammatory markers by the Akaike and Bayesian information criteria.

Conclusion: In patients with unresectable/recurrent EC, low mGNRI was correlated with unfavorable prognosis and was a useful independent prognostic factor.

Keywords: C-reactive protein; Geriatric nutrition risk index; esophageal cancer; nutrition; prognostic factor.