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Geriatric Nutritional Risk Index as a prognostic marker in patients with extensive-stage disease small cell lung cancer: Results from a randomized controlled trial.

Abstract

BACKGROUND

Clinical impact of the Geriatric Nutritional Risk Index (GNRI) in patients with extensive-stage disease small cell lung cancer (ED-SCLC) have not previously been reported.

METHODS

This study analyzed 352 patients enrolled in a previous randomized phase III trial comparing the efficacy of irinotecan plus cisplatin with that of etoposide plus cisplatin as the first-line therapy for ED-SCLC. GNRI values were calculated using serum albumin levels and actual and ideal bodyweights. Patients with a GNRI > 98, 92-98, and <92 were grouped into no, low, and moderate/major risk groups, respectively.

RESULTS

The objective response rates were 63.2%, 52.6%, and 49.2% in the no, low, and moderate/major risk groups, respectively (P = 0.024). The median progression-free survival (PFS) was shorter in patients with a lower GNRI than in those with a higher GNRI (no vs. low vs. moderate/major risk group; 6.5 vs. 5.8 vs. 5.9 months, respectively; P = 0.028). There were significant differences in median overall survival (OS) according to GNRI (no vs. low vs. moderate/major risk group; 13.2 vs. 10.3 vs. 8.4 months, respectively; P < 0.001). Multivariate analysis revealed that being in the moderate/major risk group was an independent poor prognostic factor for PFS (hazard ratio [HR]: 1.300, 95% confidence interval [CI]: 1.012-1.670; P = 0.040) and OS (HR: 1.539; 95% CI: 1.069-2.216; P = 0.020).

CONCLUSIONS

This prospective study shows that a low GNRI value was associated with a poor prognosis, and it supports the relationship between systemic inflammation, nutritional status, and clinical outcomes in patients with ED-SCLC.Key points SIGNIFICANT FINDINGS OF THE STUDY: The lower GNRI group had a low response rate to chemotherapy for ED-SCLC. The HRs for PFS and OS were 1.300 and 1.539 in the patients with GNRI < 92.

WHAT THIS STUDY ADDS

Low GNRI is associated with poor prognosis in ED-SCLC.

Authors+Show Affiliations

Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea.Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea.Department of Internal Medicine, Division of Medical Oncology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.Division of Medical Oncology, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.Division of Hematology/Oncology, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.Division of Hemato-Oncology, Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Korea.Medical Research Collaborating Center, Seoul National University College of Medicine, Seoul, Korea.Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31707767

Citation

Lee, Gyeong-Won, et al. "Geriatric Nutritional Risk Index as a Prognostic Marker in Patients With Extensive-stage Disease Small Cell Lung Cancer: Results From a Randomized Controlled Trial." Thoracic Cancer, 2019.
Lee GW, Go SI, Kim DW, et al. Geriatric Nutritional Risk Index as a prognostic marker in patients with extensive-stage disease small cell lung cancer: Results from a randomized controlled trial. Thorac Cancer. 2019.
Lee, G. W., Go, S. I., Kim, D. W., Kim, H. G., Kim, J. H., An, H. J., ... Heo, D. S. (2019). Geriatric Nutritional Risk Index as a prognostic marker in patients with extensive-stage disease small cell lung cancer: Results from a randomized controlled trial. Thoracic Cancer, doi:10.1111/1759-7714.13229.
Lee GW, et al. Geriatric Nutritional Risk Index as a Prognostic Marker in Patients With Extensive-stage Disease Small Cell Lung Cancer: Results From a Randomized Controlled Trial. Thorac Cancer. 2019 Nov 10; PubMed PMID: 31707767.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Geriatric Nutritional Risk Index as a prognostic marker in patients with extensive-stage disease small cell lung cancer: Results from a randomized controlled trial. AU - Lee,Gyeong-Won, AU - Go,Se-Il, AU - Kim,Dong-Wan, AU - Kim,Hoon-Gu, AU - Kim,Joo-Hang, AU - An,Ho Jung, AU - Jang,Joung Soon, AU - Kim,Bong-Seog, AU - Hahn,Seokyung, AU - Heo,Dae Seog, Y1 - 2019/11/10/ PY - 2019/08/30/received PY - 2019/10/03/revised PY - 2019/10/04/accepted PY - 2019/11/11/entrez PY - 2019/11/11/pubmed PY - 2019/11/11/medline KW - Cachexia KW - inflammation KW - nutrition assessment KW - small cell lung carcinoma JF - Thoracic cancer JO - Thorac Cancer N2 - BACKGROUND: Clinical impact of the Geriatric Nutritional Risk Index (GNRI) in patients with extensive-stage disease small cell lung cancer (ED-SCLC) have not previously been reported. METHODS: This study analyzed 352 patients enrolled in a previous randomized phase III trial comparing the efficacy of irinotecan plus cisplatin with that of etoposide plus cisplatin as the first-line therapy for ED-SCLC. GNRI values were calculated using serum albumin levels and actual and ideal bodyweights. Patients with a GNRI > 98, 92-98, and <92 were grouped into no, low, and moderate/major risk groups, respectively. RESULTS: The objective response rates were 63.2%, 52.6%, and 49.2% in the no, low, and moderate/major risk groups, respectively (P = 0.024). The median progression-free survival (PFS) was shorter in patients with a lower GNRI than in those with a higher GNRI (no vs. low vs. moderate/major risk group; 6.5 vs. 5.8 vs. 5.9 months, respectively; P = 0.028). There were significant differences in median overall survival (OS) according to GNRI (no vs. low vs. moderate/major risk group; 13.2 vs. 10.3 vs. 8.4 months, respectively; P < 0.001). Multivariate analysis revealed that being in the moderate/major risk group was an independent poor prognostic factor for PFS (hazard ratio [HR]: 1.300, 95% confidence interval [CI]: 1.012-1.670; P = 0.040) and OS (HR: 1.539; 95% CI: 1.069-2.216; P = 0.020). CONCLUSIONS: This prospective study shows that a low GNRI value was associated with a poor prognosis, and it supports the relationship between systemic inflammation, nutritional status, and clinical outcomes in patients with ED-SCLC.Key points SIGNIFICANT FINDINGS OF THE STUDY: The lower GNRI group had a low response rate to chemotherapy for ED-SCLC. The HRs for PFS and OS were 1.300 and 1.539 in the patients with GNRI < 92. WHAT THIS STUDY ADDS: Low GNRI is associated with poor prognosis in ED-SCLC. SN - 1759-7714 UR - https://www.unboundmedicine.com/medline/citation/31707767/Geriatric_Nutritional_Risk_Index_as_a_prognostic_marker_in_patients_with_extensive-stage_disease_small_cell_lung_cancer:_Results_from_a_randomized_controlled_trial L2 - https://doi.org/10.1111/1759-7714.13229 DB - PRIME DP - Unbound Medicine ER -