The Geriatric Nutritional Risk Index Predicts Overall Survival in Geriatric Patients with Metastatic Lung Adenocarcinoma

Abstract

The geriatric nutritional risk index (GNRI) is a simplified nutritional assessment. This study aimed to evaluate the prognostic value of the pretreatment GNRI in geriatric patients with metastatic lung adenocarcinoma (MLA). The clinicopathological characteristics of 144 geriatric patients with MLA were analyzed. The receiver operating characteristic curve was used to determine the best cutoff value of GNRI for predicting overall survival (OS). The Cox regression was used to identify variables associated with OS in the whole group, the non-sensitizing EGFR mutation subgroup, and the sensitizing EGFR mutation subgroup. The best cutoff value of the GNRI was 97 and the incidence of malnutrition risk was 52.1%. Low GNRI were significantly associated with older age (p = 0.002), a high ECOG score (p = 0.037), and a high neutrophil/lymphocyte ratio (p = 0.004). Low GNRI (p < 0.001), liver metastases (p < 0.001), and EGFR mutations (p < 0.001) were independent prognostic factors of OS. Low GNRI (p = 0.001), liver metastases (p < 0.001), and a high ECOG score (p = 0.003) were independent prognostic factors of OS in the non-sensitizing EGFR mutation subgroup, but not in the sensitizing EGFR mutation subgroup. This study shows the importance of the GNRI in predicting OS in geriatric patients with MLA, especially in patients without sensitizing EGFR mutations.

Acknowledgments

We thank Ellen Knapp, PhD, from Liwen Bianji, Edanz Group China (www.liwenbianji.cn/ac), for editing the English text of a draft of this manuscript.

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Author Contributions

Conception and Design: M. Tang, L. Li. Data Collection: M. Tang, X.N. Wu, P. Zhang, H. Wang. Analysis and Interpretation of Data: M. Tang, L. Li, X.N. Wu, P. Zhang, H. Wang. Manuscript Writing: M. Tang, P. Zhang, X.N. Wu, H. Wang, L. Li. Approval of Final Article: M. Tang, L. Li, P. Zhang, X.N. Wu, H. Wang.

Availability of Data and Materials

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request

Additional information

Funding

This study was funded by Chinese Academy of Medical Science Innovation Fund for Medical Sciences (2018-I2M-1-002) and Beijing Hospital Project (BJ-2015-125).