Prgnostic factors in lung cancer: is preoperative Geriatric Nutritional Risk Index an independent predictive factor?

Abstract

The correlation between nutritional status and survival in patient with organ malignancies, including lung cancer, is well done. Previous studies supported the use of the Geriatric Nutritional Risk Index (GNRI) as a survival prognostic factor due to the significant association with nutritional parameters and both, short and long-term outcomes.

The main aim of this study is to evaluate the GNRI as an independent prognostic factor of survival in geriatric patients with lung cancer who underwent pulmonary resection.

Methods: Retrospective study (2010-2018) that included geriatric patients (>65 years) with major elective pulmonary resection for lung cancer. Clinical characteristics, management and outcomes were colleted. The GNRI score was calculated as 1.487 serum albumin concentration (g/L) + 41.7 preoperative body weight/ideal body weight (kg). Patients were divided in group A (GNRI>98) and grupo B (≤98), this group was at risk of malnutrition. Univariate survival analysis was undertaken using the log-rank test. Cox regression multivariate analysis was carried out accounting for different variables.

Results: 341 patients were included, 326 in Group A and 15 in group B. There weren´t differences in ECOG status, gender, BMI, age, Charlson score or previous adjuvant treatment (chemotherapy or radiotherapy). Univariate and multivarate analysis didnot show statistically significant differences in survival by GNRI group (p 0.296, p 0.965 respectively).

Conclusions: GNRI isnot an independent predictive factor for survival in our cohort. However, sample size, specially in group at greatest risk of malnutrition could explain our results.