Objective: The Geriatric Nutritional Risk Index (GNRI) is a simple and well-established nutritional assessment tool and is a significant prognostic factor in various cancers. However, the role of the GNRI in predicting clinical outcomes in patients with advanced head and neck cancer (AHNC) has not been investigated. The aim of the present study was to examine the association between the GNRI and prognosis in patients with AHNC.
Study design: Retrospective cohort study.
Methods: Data collected between 2002 and 2013 from Tsukuba University Hospital were reviewed. The GNRI was calculated according to the equation, 1.489 × serum albumin (g/l) + 41.7 × (body weight/ideal body weight). Characteristics and prognosis were compared among three risk groups: high (GNRI <82); intermediate (GNRI 82-98); and normal (GNRI >98). The primary endpoint was overall survival.
Results: A total of 248 AHNC patients were enrolled, among whom 134 (54%) exhibited no nutritional risk, 53 (21%) had an intermediate risk for malnutrition, and 61 (25%) exhibited a high risk for malnutrition. Three-year survival rates according to the three-group GNRI scores for normal, intermediate, and high risk were 76.6%, 56.3%, and 19.5%, respectively. As the three-group GNRI score increased, the risk for mortality significantly increased (adjusted hazard ratio [HR] for intermediate to normal, 1.73 [95% CI, 1.02-2.92]; adjusted HR for high to normal, 4.31 [95% CI, 2.71-6.84]).
Conclusions: The GNRI could be considered a useful prognostic factor in patients with AHNC.
Level of evidence: 4 Laryngoscope, 2020.
Keywords: Advanced head and neck cancer, GNRI, hazard ratio, overall survival, prognostic factor.
© 2020 The American Laryngological, Rhinological and Otological Society, Inc.
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- Ferris RL, Blumenschein G Jr, Fayette J, et al. Nivolumab for recurrent squamous-cell carcinoma of the head and neck. N Engl J Med 2016;375:1856-1867.
- Nakayama M, Tabuchi K, Hara A. Clinical utility of the modified Glasgow prognostic score in patients with advanced head and neck cancer. Head Neck 2015;37:1745-1749.
- Matsumura T, Mitani Y, Oki Y, et al. Comparison of geriatric nutritional risk index scores on physical performance among elderly patients with chronic obstructive pulmonary disease. Heart Lung 2015;44:534-538.
- Komatsu M, Okazaki M, Tsuchiya K, Kawaguchi H, Nitta K. Geriatric nutritional risk index is a simple predictor of mortality in chronic hemodialysis patients. Blood Purif 2015;39:281-287.
- Kaneko H, Suzuki S, Goto M, et al. Geriatric nutritional risk index in hospitalized heart failure patients. Int J Cardiol 2015;181:213-215.