Prognostic Role of Pretreatment Geriatric Nutritional Risk Index in Colorectal Cancer Patients: A Meta-Analysis

Abstract

To identify the prognostic value of the pretreatment geriatric nutritional risk index (GNRI) in colorectal cancer. Several electronic databases were searched up to March 15, 2022, for relevant studies. The primary and secondary outcomes were overall survival (OS) and disease-free survival (DFS), respectively. The hazard ratios (HRs) with 95% confidence intervals (CIs) were combined. Bess’s funnel plot and Egger’s test were conducted to detect publication bias, and the trim-and-fill method was performed to identify potentially unpublished papers and their impacts on the overall results. Nine studies from Japan and China involving 3440 participants were enrolled in the current meta-analysis. The pooled results indicated that a low pretreatment GNRI was significantly associated with poorer OS (HR = 2.28, 95% CI: 1.69–3.07, P < 0.001; I²=63.5%, P_{heterogeneity}=0.005) and DFS (HR = 1.62, 95% CI: 1.35–1.96, P < 0.001; I²=46.4%, P_{heterogeneity}=0.114). Subgroup analysis stratified by country and treatment showed similar results. Significant publication bias was manifested by the asymmetric Begg’s funnel plot and P = 0.012 of Egger’s test, but three potentially unpublished studies did not have a significant impact on the overall results. A lower pretreatment GNRI was a novel prognostic risk factor for Japanese and Chinese colorectal cancer patients.

Authors’ Contributions

Jingjing An conceived and designed the analyses. Feng Yuan, Qian Yuan and Jianrong Hu performed the literature search and selection, collected data, and wrote the paper. Feng Yuan performed statistical analyses. All authors contributed substantially to its revision.

Disclosure Statement

The authors declare that there are no competing interests associated with this manuscript.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not needed.

Data Availability Statement

All data used in this meta-analysis are presented in the manuscript.

Funding

The author(s) reported there is no funding associated with the work featured in this article.