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Low Geriatric Nutritional Risk Index (GNRI) Predicts Poorer Survival in Patients with Obstructive Colorectal Cancer Who Had a Self-Expandable Metallic Stent (SEMS) Inserted as a Bridge to Curative Surgery

OBJECTIVES: The geriatric nutritional risk index (GNRI) is a nutrition-related risk index calculated easily from serum albumin and the ratio of body weight to ideal body weight. We investigated the prognostic values of the GNRI in elderly patients with obstructive colorectal cancer (OCRC) who had a...

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Autores principales: Sato, Ryuichiro, Oikawa, Masaya, Kakita, Tetsuya, Okada, Takaho, Abe, Tomoya, Tsuchiya, Haruyuki, Akazawa, Naoya, Ohira, Tetsuya, Harada, Yoshihiro, Okano, Haruka, Ito, Kei, Tsuchiya, Takashi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japan Society of Coloproctology 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10129360/
https://www.ncbi.nlm.nih.gov/pubmed/37113588
http://dx.doi.org/10.23922/jarc.2022-053
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author Sato, Ryuichiro
Oikawa, Masaya
Kakita, Tetsuya
Okada, Takaho
Abe, Tomoya
Tsuchiya, Haruyuki
Akazawa, Naoya
Ohira, Tetsuya
Harada, Yoshihiro
Okano, Haruka
Ito, Kei
Tsuchiya, Takashi
author_facet Sato, Ryuichiro
Oikawa, Masaya
Kakita, Tetsuya
Okada, Takaho
Abe, Tomoya
Tsuchiya, Haruyuki
Akazawa, Naoya
Ohira, Tetsuya
Harada, Yoshihiro
Okano, Haruka
Ito, Kei
Tsuchiya, Takashi
author_sort Sato, Ryuichiro
collection PubMed
description OBJECTIVES: The geriatric nutritional risk index (GNRI) is a nutrition-related risk index calculated easily from serum albumin and the ratio of body weight to ideal body weight. We investigated the prognostic values of the GNRI in elderly patients with obstructive colorectal cancer (OCRC) who had a self-expandable metallic stent inserted as a bridge to curative surgery. METHODS: We retrospectively evaluated 61 patients aged ≥65 years with pathological stage I to III OCRC. Associations of preoperative GNRI and pre-stenting GNRI (ps-GNRI) with short- and long-term outcomes were examined. RESULTS: Multivariate analyses revealed GNRI of <85.3 and ps-GNRI of <92.9 were independently associated with worse cancer-specific survival (CSS; P = 0.016, and P = 0.041, respectively), and overall survival (OS; P = 0.020, and P = 0.024, respectively). A ps-GNRI of <92.9 was correlated with poorer relapse-free survival (RFS) only in the univariate analysis (P = 0.034). For the OCRC cohort without age restriction (n = 86), GNRI of <85.3 and ps-GNRI of <92.9 were independently associated with worse CSS (P = 0.021), and OS (P = 0.023), respectively. In univariate analysis, ps-GNRI of <92.9 was significantly correlated with poorer RFS (P = 0.006). Moreover, ps-GNRI of <92.9 was significantly associated with Clavien-Dindo grade of ≥III postoperative complications (P = 0.037), anastomotic leak (P = 0.032), infectious complications (P = 0.002), and longer postoperative hospital stay (17 days vs. 15 days; P = 0.048). CONCLUSIONS: In OCRC patients, decreased preoperative and pre-stenting GNRI were significantly correlated with poorer survival, and decreased pre-stenting GNRI was significantly associated with worse short- and long-term outcomes.
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spelling pubmed-101293602023-04-26 Low Geriatric Nutritional Risk Index (GNRI) Predicts Poorer Survival in Patients with Obstructive Colorectal Cancer Who Had a Self-Expandable Metallic Stent (SEMS) Inserted as a Bridge to Curative Surgery Sato, Ryuichiro Oikawa, Masaya Kakita, Tetsuya Okada, Takaho Abe, Tomoya Tsuchiya, Haruyuki Akazawa, Naoya Ohira, Tetsuya Harada, Yoshihiro Okano, Haruka Ito, Kei Tsuchiya, Takashi J Anus Rectum Colon Original Research Article OBJECTIVES: The geriatric nutritional risk index (GNRI) is a nutrition-related risk index calculated easily from serum albumin and the ratio of body weight to ideal body weight. We investigated the prognostic values of the GNRI in elderly patients with obstructive colorectal cancer (OCRC) who had a self-expandable metallic stent inserted as a bridge to curative surgery. METHODS: We retrospectively evaluated 61 patients aged ≥65 years with pathological stage I to III OCRC. Associations of preoperative GNRI and pre-stenting GNRI (ps-GNRI) with short- and long-term outcomes were examined. RESULTS: Multivariate analyses revealed GNRI of <85.3 and ps-GNRI of <92.9 were independently associated with worse cancer-specific survival (CSS; P = 0.016, and P = 0.041, respectively), and overall survival (OS; P = 0.020, and P = 0.024, respectively). A ps-GNRI of <92.9 was correlated with poorer relapse-free survival (RFS) only in the univariate analysis (P = 0.034). For the OCRC cohort without age restriction (n = 86), GNRI of <85.3 and ps-GNRI of <92.9 were independently associated with worse CSS (P = 0.021), and OS (P = 0.023), respectively. In univariate analysis, ps-GNRI of <92.9 was significantly correlated with poorer RFS (P = 0.006). Moreover, ps-GNRI of <92.9 was significantly associated with Clavien-Dindo grade of ≥III postoperative complications (P = 0.037), anastomotic leak (P = 0.032), infectious complications (P = 0.002), and longer postoperative hospital stay (17 days vs. 15 days; P = 0.048). CONCLUSIONS: In OCRC patients, decreased preoperative and pre-stenting GNRI were significantly correlated with poorer survival, and decreased pre-stenting GNRI was significantly associated with worse short- and long-term outcomes. The Japan Society of Coloproctology 2023-04-25 /pmc/articles/PMC10129360/ /pubmed/37113588 http://dx.doi.org/10.23922/jarc.2022-053 Text en Copyright © 2023 The Japan Society of Coloproctology https://creativecommons.org/licenses/by-nc-nd/4.0/Journal of the Anus, Rectum and Colon is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Research Article
Sato, Ryuichiro
Oikawa, Masaya
Kakita, Tetsuya
Okada, Takaho
Abe, Tomoya
Tsuchiya, Haruyuki
Akazawa, Naoya
Ohira, Tetsuya
Harada, Yoshihiro
Okano, Haruka
Ito, Kei
Tsuchiya, Takashi
Low Geriatric Nutritional Risk Index (GNRI) Predicts Poorer Survival in Patients with Obstructive Colorectal Cancer Who Had a Self-Expandable Metallic Stent (SEMS) Inserted as a Bridge to Curative Surgery
title Low Geriatric Nutritional Risk Index (GNRI) Predicts Poorer Survival in Patients with Obstructive Colorectal Cancer Who Had a Self-Expandable Metallic Stent (SEMS) Inserted as a Bridge to Curative Surgery
title_full Low Geriatric Nutritional Risk Index (GNRI) Predicts Poorer Survival in Patients with Obstructive Colorectal Cancer Who Had a Self-Expandable Metallic Stent (SEMS) Inserted as a Bridge to Curative Surgery
title_fullStr Low Geriatric Nutritional Risk Index (GNRI) Predicts Poorer Survival in Patients with Obstructive Colorectal Cancer Who Had a Self-Expandable Metallic Stent (SEMS) Inserted as a Bridge to Curative Surgery
title_full_unstemmed Low Geriatric Nutritional Risk Index (GNRI) Predicts Poorer Survival in Patients with Obstructive Colorectal Cancer Who Had a Self-Expandable Metallic Stent (SEMS) Inserted as a Bridge to Curative Surgery
title_short Low Geriatric Nutritional Risk Index (GNRI) Predicts Poorer Survival in Patients with Obstructive Colorectal Cancer Who Had a Self-Expandable Metallic Stent (SEMS) Inserted as a Bridge to Curative Surgery
title_sort low geriatric nutritional risk index (gnri) predicts poorer survival in patients with obstructive colorectal cancer who had a self-expandable metallic stent (sems) inserted as a bridge to curative surgery
topic Original Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10129360/
https://www.ncbi.nlm.nih.gov/pubmed/37113588
http://dx.doi.org/10.23922/jarc.2022-053
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