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Using the geriatric nutritional risk index to predict outcomes in older patients with remnant gastric cancer after gastrectomy: a retrospective multicenter study in Japan

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Abstract

Purpose

This study investigated the prognostic value of the geriatric nutritional risk index (GNRI) in patients undergoing curative gastrectomy for remnant gastric cancer (RGC).

Methods

This multicenter retrospective study included 105 patients with RGC of ≥ 65 years of age who underwent curative gastrectomy at 10 institutions in Japan between January 2000 and December 2016. Postoperative complications, overall survival (OS), and disease-specific survival (DSS) were analyzed.

Results

Receiver operating curve analyses indicated that the optimal cutoff value of the GNRI for OS was 95.4. Patients were categorized into high and low GNRI groups based on the optimal GNRI cutoff value. The GNRI was significantly correlated with body mass index (p < 0.001), amount of bleeding (p = 0.021), Clavien–Dindo grade 5 postoperative complications (p = 0.040), death caused by primary disease (p = 0.010), and death caused by other diseases (p = 0.002). The OS and DSS were significantly worse in the low GNRI group. A low GNRI and T3 or deeper tumor invasion were independent prognostic factors for OS and DSS.

Conclusions

The GNRI is a promising predictor of both short- and long-term outcomes in older patients with RGC.

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Availability of data and materials

The datasets used and/or analyzed in the current study are available upon reasonable request from the corresponding author.

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Acknowledgements

We thank Enago Group for editing a draft of this manuscript.

Author information

Authors and Affiliations

  1. Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-Cho, Yonago, Yonago, 683-8504, Japan

    Tomoyuki Matsunaga, Shota Shimizu, Yuji Shishido, Kozo Miyatani, Teruhisa Sakamoto & Yoshiyuki Fujiwara

  2. Department of Surgery, Japanese Red Cross Tottori Hospital, Tottori, 680-8517, Japan

    Hiroaki Saito

  3. Department of Surgery, Tottori Prefectural Central Hospital, Tottori, 680-0901, Japan

    Tomohiro Osaki

  4. Department of Surgery, Sanin Rosai Hospital, Yonago, 683-8605, Japan

    Kenji Fukuda

  5. Division of Gastroenterology, Matsue City Hospital, Matsue, 690-8509, Japan

    Yoji Fukumoto

  6. National Hospital Organization, Hamada Medical Center, Hamada, 697-8511, Japan

    Sadamu Takahashi

  7. Department of Surgery, Yonago Medical Center of National Hospital Organization, Yonago, 683-0006, Japan

    Kenjiro Taniguchi

  8. Division of Digestive Surgery, Tottori Prefectural Kousei Hospital, Kurayoshi, 682-0804, Japan

    Akemi Iwamoto

  9. Department of Surgery, Japanese Red Cross Masuda Hospital, Masuda, 698-8501, Japan

    Hirohiko Kuroda

  10. Department of Surgery, Nanbu Town National Health Insurance Saihaku Hospital, Nanbu, 683-0323, Japan

    Kuniyuki Katano

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  1. Tomoyuki Matsunaga
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Corresponding author

Correspondence to Tomoyuki Matsunaga.

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Conflict of interest

The authors state that they do not have any competing interests.

Ethics approval and consent to participate

All procedures were performed following the ethical standards of the responsible committee on human experimentation (institutional and national) as well as the 1964 Declaration of Helsinki and subsequent revisions. The study protocol was approved by the institutional review boards of each participating hospital [Tottori University Hospital ethics committee (19A133); Japanese Red Cross Tottori Hospital ethics committee (82-3); Tottori Prefectural Central Hospital ethics committee (2020-1); Sanin Rosai Hospital ethics committee (2020-13); Matsue City Hospital ethics committee (2A-0005); Hamada Medical Center ethics committee (3072); Yonago Medical Center ethics committee (0204-02); ethics committee of Tottori Prefectural Kousei Hospital (207); Masuda Red Cross Hospital Medical Ethics Committee (75); Saihaku Hospital ethics committee (20072)]. In this retrospective study, the patients were not required to provide informed consent because the analyses relied on anonymous clinical data obtained after each patient agreed to treatment in writing. We also used an opt-out method on the website to obtain consent for this study, which was approved by the institutional review board.

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Matsunaga, T., Saito, H., Osaki, T. et al. Using the geriatric nutritional risk index to predict outcomes in older patients with remnant gastric cancer after gastrectomy: a retrospective multicenter study in Japan. Surg Today (2024). https://doi.org/10.1007/s00595-024-02850-w

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