Prognostic Value of the Geriatric Nutritional Risk Index in Non-Small Cell Lung Cancer Patients: A Systematic Review and Meta-Analysis
What this study found
Lower pre-treatment GNRI is associated with poorer survival in NSCLC: OS HR 1.99 (95% CI 1.68–2.35; I2=25%), CSS HR 2.45 (95% CI 1.43–4.18; I2=0%), and RFS HR 2.34 (95% CI 1.11–4.95; I2=55%). Subgroup analyses by region, tumor stage, therapy, sample size, GNRI cutoff, and publication year showed consistent associations. Sensitivity analysis supported robustness; trim-and-fill adjusted HR 1.93 (95% CI 1.64–2.29). Conclusion: Pretreatment GNRI may be a prognostic biomarker for poorer survival in NSCLC; findings are mainly from Asian cohorts; more prospective studies in diverse populations are…
- Study & population
- Eight studies (n=2,399) in non-small cell lung cancer; designs were predominantly retrospective with one prospective; populations from Japan and China; pre-treatment GNRI used to predict OS, CSS, and RFS; GNRI cutoff values varied (≈98–102); NOS quality scores ranged from 6 to 9; HRs and 95% CIs were extracted; meta-analysis used fixed- or random-effects…
- Key limitation
- Eight studies; mostly retrospective; Asian cohorts (Japan and China) limit generalizability; heterogeneity in GNRI cutoffs and patient characteristics; limited data for CSS and RFS; potential residual confounding.
View source
Open PDFOriginal abstract
Background Novel evidence showed that the Geriatric Nutritional Risk Index (GNRI) may lead to poor prognosis of human cancers. Therefore, we conducted a meta-analysis to explore the impact of GNRI in lung cancer and its prognostic value. Methods We searched the databases of PubMed, Web of Science, Embase, Scopus, and Cochrane Library up to July 2021 for relevant research and merged the hazard ratios (HRs) and 95% confidence intervals (CIs) to evaluate the association between GNRI and overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS) in patients with lung cancer. Results Eight studies involving 2,399 patients were included in our primary meta-analysis. The results indicated that lower level of GNRI was associated with poorer OS, RFS, and CSS of lung cancer patients (OS: HR = 1.99, 95% CI: 1.68–2.35, p < 0.0001; RFS: HR = 2.34, 95% CI: 1.11–4.95, p = 0.0258; CSS: HR = 2.45, 95% CI: 1.43–4.18, p = 0.0011). The association was robust after subgroup analysis and sensitivity analysis. Conclusions GNRI may be a prognostic factor of lung cancer, which can lead to poorer survival. However, more prospective studies are necessary to confirm the results. Systematic Review Registration International Prospective Register of Systematic Reviews (PROSPERO), identifier CRD42021269574.