Utility of Geriatric Nutritional Risk Index in patients with lung cancer undergoing surgery

OBJECTIVES: The Geriatric Nutritional Risk Index (GNRI) based on serum albumin and body weight helps predict the risk of malnutrition and mortality in hospitalized elderly patients. However, its significance for patients with malignancy is unclear. We analysed the ability of GNRI to assess this risk in patients with lung cancer undergoing surgery. METHODS: We retrospectively analysed the clinical characteristics and surgical outcomes of 739 patients with primary lung cancer who underwent surgery from 2006 to 2017 in a single institution. RESULTS: GNRI values were <98 for 112 patients and >98 for 627 patients; 532 patients had pathological stage I disease, 114 patients had stage II disease and 93 patients had stage III disease. Cox proportional hazards models revealed that age, GNRI value <98 and stages II and III diseases (all Ps < 0.05) were significant negative prognostic factors for overall survival and that carcinoembryonic antigen level (P = 0.03), GNRI value <98 (P = 0.005) and stages II and III diseases (both Ps < 0.001) were significant negative prognostic factors for cancer-specific survival. Rates of overall survival and cancer-specific survival stratified by lower and higher GNRI score were significantly different among patients aged 70 and older (P = 0.001 and P = 0.004, respectively) but not among patients aged 69 and younger (P = 0.09 and P = 0.12, respectively). CONCLUSIONS: GNRI could help in predicting survival after lung cancer surgery, especially in older patients, and perioperative active nutritional support might improve the survival.