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Oncotarget: Geriatric nutritional risk index - prognostic marker of esophageal carcinoma


Oncotarget Volume 11, Issue 29 reported that In multivariate analyses, serum albumin, GNRI, pathological tumor-node-metastasis stage, and tumor differentiation were independent prognostic factors for CSS.

In pTNM stage I, multivariate analysis identified C-reactive protein and GNRI as independent prognostic factors for CSS.

In univariate analyses in pTNM stages II and III, only low GNRI and low serum albumin levels, respectively, were significantly associated with worse CSS.

In patients with low GNRI, CSS was significantly worse than in those with normal GNRI, especially in pTNM stages I and II groups, but not in stage III group.

Preoperative GNRI may sort patients into low- or high-risk groups for shorter CSS, especially in those with pTNM stage I and II ESCC.

Dr. Noriyuki Hirahara from The Shimane University Faculty of Medicine said, "Patients with advanced esophageal cancer presenting with dysphagia often experience malnutrition as well as impairment of performance status and quality of life."

Figure 4: ROC for cancer death was plotted to verify the optimum cutoff of GNRI. Abbreviation: ROC, receiver operating characteristic.

Serum albumin is a clinically relevant indicator of nutritional status, such as malnutrition and cachexia.

Recently, it has been widely accepted that the GNRI was strongly associated with mortality in elderly hospitalized patients and in patients with various cancers.

However, to the best of the authors knowledge, there have been few reports on the prognostic significance of the GNRI in patients with esophageal squamous cell carcinoma.

In this study, they have investigated whether the GNRI is a useful predictor of long-term survivals in patients with ESCC who underwent a curative esophagectomy.

"In this study, they have investigated whether the GNRI is a useful predictor of long-term survivals in patients with ESCC who underwent a curative esophagectomy"

The Hirahara Research Team concluded in their Oncotarget Research Paper that, "preoperative GNRI can be used to sort patients into groups at high- or low-risk for shorter CSS after undergoing curative resection for ESCC, especially those with pTNM stage I and II ESCC; the interpretation should be done with care due to the differences in clinical background. Therefore, multicenter prospective validation of our findings is considered necessary to confirm the usefulness of GNRI as clinical therapeutic stratification marker for patients requiring more aggressive multimodality treatment or stringing surveillance.

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DOI - https://doi.org/10.18632/oncotarget.27670

Full text - https://www.oncotarget.com/article/27670/text/

Correspondence to - Noriyuki Hirahara - norinorihirahara@yahoo.co.jp

Keywords - geriatric nutritional risk index, esophageal squamous cell carcinoma, curative esophagectomy, cancer-specific survival, pathological tumor-node-metastasis

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