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Geriatric nutritional risk index as a prognostic factor in elderly patients with non-muscle-invasive bladder cancer: a propensity score-matched study

  • Urology - Original Paper
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Abstract

Purpose

The Geriatric Nutrition Risk Index (GNRI) is a simple and validated tool used to assess the nutritional status of elderly patients and predict the risk of short-term postoperative complications, as well as the long-term prognosis, after cancer surgery. In this study, we aimed to evaluate the predictive value of GNRI for the long-term postoperative prognosis in elderly patients with primary non-muscle-invasive bladder cancer (NMIBC) who underwent transurethral resection of bladder tumor (TURBT).

Methods

We retrospectively analyzed data from 292 elderly patients with primary NMIBC. Using X-tile software, we divided the cohort into two groups based on GNRI and determined the cut-off value for postoperative recurrence-free survival (RFS). Propensity score matching (PSM) with a ratio of 1:3, Kaplan–Meier analysis, log-rank test, and COX proportional hazards regression were used to assess the correlation between GNRI and prognosis and identify factors predicting recurrence and progression.

Results

In the entire cohort, the 3 year recurrence group had significantly lower GNRI compared to the 3 year non-recurrence group (P = 0.0109). The determined GNRI cut-off value was 93.82. After PSM, the low GNRI group had significantly lower RFS (P < 0.0001) and progression-free survival (PFS) (P = 0.0040) than the high GNRI group. Multivariate COX regression showed that GNRI independently predicted RFS (HR 2.108; 95% CI 1.266–3.512; P = 0.004) and PFS (HR 2.155; 95% CI 1.135–4.091; P = 0.019) in elderly patients with primary NMIBC.

Conclusion

Preoperative GNRI is a prognostic marker for disease recurrence and progression in elderly patients with primary NMIBC undergoing TURBT.

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Data availability

The data supporting the results of this study were available at the corresponding author if reasonably requested.

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Funding

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Author notes

  1. Jingxin Wu, Xiaofeng Cheng and Heng Yang have contributed equally to this work .

Authors and Affiliations

  1. Department of Urological Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, 330000, Jiangxi, China

    Jingxin Wu, Xiaofeng Cheng, Heng Yang, Song Xiao, Linhao Xu, Cheng Zhang, Wei Huang, Chunwen Jiang & Gongxian Wang

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  1. Jingxin Wu
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Contributions

The design of this study, data collection, and writing of the manuscript were done by JXW, XFC, and HY. LHX, SX, and CWJ: contributed to the follow-up and data analysis. WH, CZ, and GXW: supervised the whole project, discussed the analysis results, and reviewed the manuscript, All authors participated in the final review of the manuscript and agreed to submit the manuscript.

Corresponding author

Correspondence to Gongxian Wang.

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The authors declare that they have no conflict of interests.

Ethical approval

This study was conducted in accordance with the Declaration of Helsinki. The study was approved by the Ethics Review Board of the First Affiliated Hospital of Nanchang University.

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All clinical data come from the inpatient system and the outpatient system, so the consent of the patient is no longer required.

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Wu, J., Cheng, X., Yang, H. et al. Geriatric nutritional risk index as a prognostic factor in elderly patients with non-muscle-invasive bladder cancer: a propensity score-matched study. Int Urol Nephrol 56, 1627–1637 (2024). https://doi.org/10.1007/s11255-023-03905-6

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