SEARCHCOHORToncology, clinical nutrition

cohort·oncology, clinical nutrition, internal medicine, surgery, nutrition·PMC10027676

Geriatric nutritional risk index as a prognostic marker for patients with upper tract urothelial carcinoma receiving radical nephroureterectomy

Scientific Reports · 14 authors, 9 centres

AI SUMMARY

FIDELITY 100%

POPULATION488 patients with upper tract urothelial carcinoma (UTUC) who underwent radical nephroureterectomy (RNU) between January 2001 and December 2015.

INTERVENTIONCalculation of preoperative geriatric nutritional risk index (GNRI) based on serum albumin and body mass index.

COMPARISONPatients with normal nutritional status (GNRI ≥ 92) vs. patients with malnutritional status (GNRI < 92).

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TL;DR

This retrospective cohort study investigated the prognostic value of the preoperative geriatric nutritional risk index (GNRI) in 488 patients with upper tract urothelial carcinoma undergoing radical nephroureterectomy. The study found that a low GNRI (malnutritional status) was an independent risk factor for worse disease-free, cancer-specific, and overall survival.

Full summary

1,225 CHARS

This retrospective cohort study analyzed 488 patients with upper tract urothelial carcinoma (UTUC) who underwent radical nephroureterectomy (RNU). The preoperative geriatric nutritional risk index (GNRI) was calculated to categorize patients into normal nutritional status (GNRI ≥ 92, n=386) and malnutritional status (GNRI < 92, n=102). The primary outcomes were disease-free survival (DFS), cancer-specific survival (CSS), and overall survival (OS). Kaplan-Meier analysis and multivariate Cox regression were used. The 5-year survival rates for DFS, CSS, and OS were significantly lower in the malnutritional group (28.0%, 53.2%, 40%) compared to the normal group (48.6%, 80.5%, 80.5%). Multivariate analysis identified malnutritional status as an independent risk factor for OS (HR=3.94), DFS (HR=1.90), and CSS (HR=5.42). Other independent risk factors for OS included age, positive surgical margin, pathological T3/T4 stage, and lymphovascular invasion. Limitations include the retrospective design, potential surgical confounders, and lack of data on neoadjuvant/adjuvant therapies. The findings suggest preoperative GNRI is a useful, independent prognostic marker for survival outcomes in UTUC patients undergoing RNU.

PICO

PPOPULATION

488 patients with upper tract urothelial carcinoma (UTUC) who underwent radical nephroureterectomy (RNU) between January 2001 and December 2015.

IINTERVENTION

Calculation of preoperative geriatric nutritional risk index (GNRI) based on serum albumin and body mass index.

OOUTCOME

Disease-free survival (DFS), cancer-specific survival (CSS), and overall survival (OS).

STUDY TYPE

cohort

SPECIALTY

oncology

SUMMARISED BY

AI pipeline

FIDELITY CHECK

100% · A

ORIGINAL PAPER

PMC10027676

Geriatric nutritional risk index as a prognostic marker for patients with upper tract urothelial carcinoma receiving radical nephroureterectomy

Scientific Reports

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ABSTRACT

To investigate the prognostic value of the geriatric nutritional risk index (GNRI) in patients with upper tract urothelial cell carcinoma (UTUC) receiving radical nephroureterectomy (RNU). Between January 2001 and December 2015, we enrolled 488 patients with UTUC underwent RNU in Taichung Veterans General Hospital. GNRI before radical surgery was calculated based on serum albumin level and body mass index. The malnutritional status was defined as GNRI < 92.0. Using Kaplan–Meier analyses and Cox proportional hazards models to analyze the risk factors on disease-free survival (DFS), cancer-specific survival (CSS) and overall survival (OS). 386 patients were categorized as normal nutritional status (GNRI ≥ 92) and 102 patients as malnutritional status (GNRI < 92). We used the receiver operating characteristic (ROC) curve for determined the association between GNRI and OS, with area under the curve (AUC) being 0.69. The 5-year survival rate of DFS, CSS and OS were 48.6%, 80.5% and 80.5% in the normal nutritional group and 28.0%, 53.2% and 40% in the malnutritional group. Using the multivariate analysis, malnutritional status was found as an independent risk factor for OS (hazard ratio [HR] = 3.94, 95% confidence interval [CI] 2.70–5.74), together with age (HR = 1.04, 95% CI 1.02–1.06), surgical margin positive (HR = 1.78, 95% CI 1.13–2.82), pathological T3 (HR = 2.54, 95% CI 1.53–4.21), pathological T4 (HR = 6.75, 95% CI 3.17–14.37) and lymphovascular invasion (HR = 1.81, 95% CI 1.16–2.81). We also found GNRI index as independent risk factor in DFS (HR = 1.90, 95% CI 1.42–2.54) and CSS (HR = 5.42, 95% CI 3.24–9.06). Preoperative malnutritional status with low GNRI is an independent marker in predicting DFS, CSS and OS in UTUC patients underwent RNU.

CITATION EXPORT

Li-Wen Chang, Sheng-Chun Hung, Chuan-Shu Chen et al.. Geriatric nutritional risk index as a prognostic marker for patients with upper tract urothelial carcinoma receiving radical nephroureterectomy. Scientific Reports. (2023). https://doi.org/10.1038/s41598-023-31814-2

AUTHORS

14 · 9 CENTRES

Li-Wen Chang, Sheng-Chun Hung, Chuan-Shu Chen, Jian-Ri Li, Kun-Yuan Chiu, Shian-Shiang Wang, Cheng-Kuang Yang, Kevin Lu, Cheng-Che Chen, Shu-Chi Wang, Chia-Yen Lin, Chen-Li Cheng, Yen-Chuan Ou, Shun-Fa Yang

1https://ror.org/059ryjv25grid.411641.70000 0004 0532 2041Institute of Medicine, Chung Shan Medical University, No. 110, Sec.1, Jianguo N. Rd., Taichung, 40201 Taiwan, ROC
2https://ror.org/00e87hq62grid.410764.00000 0004 0573 0731Division of Urology, Department of Surgery, Taichung Veterans General Hospital, No. 1650, Sec. 4, Taiwan Boulevard, Taichung, Taiwan, ROC
3grid.260542.70000 0004 0532 3749Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan, ROC
4https://ror.org/02f2vsx71grid.411432.10000 0004 1770 3722Department of Medicine and Nursing, Hungkuang University, Taichung, Taiwan, ROC
5https://ror.org/03ha6v181grid.412044.70000 0001 0511 9228Department of Applied Chemistry, National Chi Nan University, Nantou, Taiwan
6grid.260539.b0000 0001 2059 7017School of Medicine, National Yang Ming University, Taipei, Taiwan
7https://ror.org/00e87hq62grid.410764.00000 0004 0573 0731Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
8https://ror.org/0452q7b74grid.417350.40000 0004 1794 6820Department of Urology, Tungs’ Taichung MetroHarbor Hospital, Taichung, Taiwan, ROC
9https://ror.org/01abtsn51grid.411645.30000 0004 0638 9256Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan