Using the geriatric nutritional risk index to predict outcomes in older patients with remnant gastric cancer after gastrectomy: a retrospective multicenter study in Japan

Tomoyuki Matsunaga; Hiroaki Saito; Tomohiro Osaki; Kenji Fukuda; Yoji Fukumoto; Sadamu Takahashi; Kenjiro Taniguchi; Akemi Iwamoto; Hirohiko Kuroda; Kuniyuki Katano; Shota Shimizu; Yuji Shishido; Kozo Miyatani; Teruhisa Sakamoto; Yoshiyuki Fujiwara

doi:10.1007/s00595-024-02850-w

Using the geriatric nutritional risk index to predict outcomes in older patients with remnant gastric cancer after gastrectomy: a retrospective multicenter study in Japan

Surg Today. 2024 Apr 23. doi: 10.1007/s00595-024-02850-w. Online ahead of print.

Authors

Affiliations

¹ Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-Cho, Yonago, Yonago, 683-8504, Japan. matut0m0@tottori-u.ac.jp.
² Department of Surgery, Japanese Red Cross Tottori Hospital, Tottori, 680-8517, Japan.
³ Department of Surgery, Tottori Prefectural Central Hospital, Tottori, 680-0901, Japan.
⁴ Department of Surgery, Sanin Rosai Hospital, Yonago, 683-8605, Japan.
⁵ Division of Gastroenterology, Matsue City Hospital, Matsue, 690-8509, Japan.
⁶ National Hospital Organization, Hamada Medical Center, Hamada, 697-8511, Japan.
⁷ Department of Surgery, Yonago Medical Center of National Hospital Organization, Yonago, 683-0006, Japan.
⁸ Division of Digestive Surgery, Tottori Prefectural Kousei Hospital, Kurayoshi, 682-0804, Japan.
⁹ Department of Surgery, Japanese Red Cross Masuda Hospital, Masuda, 698-8501, Japan.
¹⁰ Department of Surgery, Nanbu Town National Health Insurance Saihaku Hospital, Nanbu, 683-0323, Japan.
¹¹ Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-Cho, Yonago, Yonago, 683-8504, Japan.

PMID: 38652300
DOI: 10.1007/s00595-024-02850-w

Abstract

Purpose: This study investigated the prognostic value of the geriatric nutritional risk index (GNRI) in patients undergoing curative gastrectomy for remnant gastric cancer (RGC).

Methods: This multicenter retrospective study included 105 patients with RGC of ≥ 65 years of age who underwent curative gastrectomy at 10 institutions in Japan between January 2000 and December 2016. Postoperative complications, overall survival (OS), and disease-specific survival (DSS) were analyzed.

Results: Receiver operating curve analyses indicated that the optimal cutoff value of the GNRI for OS was 95.4. Patients were categorized into high and low GNRI groups based on the optimal GNRI cutoff value. The GNRI was significantly correlated with body mass index (p < 0.001), amount of bleeding (p = 0.021), Clavien-Dindo grade 5 postoperative complications (p = 0.040), death caused by primary disease (p = 0.010), and death caused by other diseases (p = 0.002). The OS and DSS were significantly worse in the low GNRI group. A low GNRI and T3 or deeper tumor invasion were independent prognostic factors for OS and DSS.

Conclusions: The GNRI is a promising predictor of both short- and long-term outcomes in older patients with RGC.

Keywords: GNRI; Prognosis; Remnant gastric cancer.