Association of Pre-operative Geriatric Nutritional Risk Index With Complete Adjuvant Chemotherapy and Prognosis Post-pancreatectomy

Abstract

Background/aim: The Geriatric Nutritional Risk Index (GNRI) predicts prognosis in various cancers. This study examined the correlation between GNRI, complete adjuvant chemotherapy (AC), and prognosis in patients with resected pancreatic cancer.

Patients and methods: We retrospectively evaluated 123 patients with pancreatic cancer who underwent pancreatectomies at our institute between January 2010 and December 2020. Kaplan-Meier and Cox regression methods were used to assess survival. Factors associated with complete AC were identified using logistic regression analysis.

Results: Among the 123 patients with pancreatic cancer, 93 (75.6%) initiated AC, and 55 (44.7%) completed AC. In multivariate analysis, the pre-operative GNRI was an independent prognostic factor for overall survival (OS) [hazard ratio=1.63, 95% confidence interval (CI)=1.01-2.63; p=0.046]. Additionally, pre-operative GNRI was an independent predictor of complete AC (odds ratio=0.38, 95%CI=0.17-0.83; p=0.015). In the high (≥98) and low GNRI (<98) groups, patients who underwent complete AC had significantly longer OS than those who did not (p<0.001, respectively). However, the patients in the low GNRI group who underwent complete AC had no significant difference in OS compared to those in the high GNRI group who did not undergo complete AC (p=0.523).

Conclusion: Pre-operative GNRI may predict complete AC and prognosis in resected pancreatic cancer.

Keywords: Pancreatic cancer; complete adjuvant chemotherapy; geriatric nutritional risk index; pancreatectomy; prognosis.