Prognostic Value of the Geriatric Nutritional Risk Index in Non-Small Cell Lung Cancer Patients: A Systematic Review and Meta-Analysis

Frontiers in Oncology
Q2
Jan 2022
Citations:26
Influential Citations:2
Systematic Reviews / Meta-Analyses
82
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Enhanced Details

Methods
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 models based on heterogeneity.
Results
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 needed to confirm and to explore whether improving GNRI could improve outcomes.
Limitations
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.

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 s...