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Prognostic value of preoperative geriatric nutritional risk index in intrahepatic cholangiocarcinoma after hepatectomy: a single‑center retrospective cohort study

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Abstract

Aim

Patients with malignant tumors are prone to develop nutritional disorders. The Geriatric Nutritional Risk Index (GNRI) is a new prognostic indicator for assessing the nutritional status. This study was performed to evaluate whether the preoperative GNRI can serve as a prognostic factor in patients with intrahepatic cholangiocarcinoma (ICC) undergoing curative surgery.

Methods

This study included 123 consecutive patients with ICC who were treated with curative surgery. Kaplan–Meier analysis was performed to calculate the recurrence-free survival (RFS) and overall survival (OS), and Cox regression analysis was used to evaluate prognostic factors.

Results

Of the 123 patients, 82 were male and 41 were female. The median age of the patients was 70 years, and the median follow-up period was 37.0 months (interquartile range, 16.2–71.7 months). The patients were classified by the median GNRI into a low GNRI group (GNRI < 105) and high GNRI group (GNRI ≥ 105). The patients in the low GNRI group had a significantly poorer prognosis in terms of RFS and OS than the patients in the high GNRI group (RFS, p = 0.0201; OS, p < 0.0001). Lymph node metastasis [hazard ratio (HR), 4.66; 95% confidence interval (CI), 2.46–8.85], postoperative complications (HR, 2.38; 95% CI, 1.32–4.31), and a low GNRI (HR, 2.53; 95% CI, 1.42–4.50) were independent poor prognostic factors for OS.

Conclusion

The GNRI may be a useful prognostic indicator in patients with ICC undergoing curative hepatectomy.

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Data availability

Raw data were generated at Department of Gastroenterological Surgery, Graduate School of Life Sciences Kumamoto University. Derived data supporting the findings of this study are available from the corresponding author H.B on request.

Abbreviations

ICC:

Intrahepatic cholangiocarcinoma

GNRI:

Geriatric Nutritional Risk Index

CEA:

Carcinoembryonic antigen

CA19-9:

Carbohydrate antigen 19–9

RFS:

Recurrence-free survival

OS:

Overall survival

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Acknowledgements

We thank Angela Morben, DVM, ELS, from Edanz (https://jp.edanz.com/ac), for editing a draft of this manuscript.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, 1-1 Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan

    Daisuke Ogawa, Tatsunori Miyata, Shinsei Yumoto, Yuta Shiraishi, Takashi Matsumoto, Toru Takematsu, Masayo Tsukamoto, Shigeki Nakagawa, Kosuke Mima, Hidetoshi Nitta, Hiromitsu Hayashi & Hideo Baba

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  1. Daisuke Ogawa
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  2. Tatsunori Miyata
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Contributions

DO wrote the main manuscript text and prepared all figures and tables.

SY, YS, TM, TT, MT, SN, KM, HN collaborated and advised on this study. TM, KM and HH determined the study plan.

HB provided critical review of clinical findings. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Daisuke Ogawa.

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Competing interests

The authors declare no competing interests.

Competing interest

The authors declare no competing interests.

Ethics approval

The protocol for this research project has been approved by a suitably constituted ethics committee of the institution, and it conforms to the provisions of the Declaration of Helsinki (Ethics Committee and Clinical Trial Review Committee of Kumamoto University Hospital; Approval No. 1800). Written informed consent was obtained from the patients for publication of this report. A copy of the written consent is available for review by the Editor-in-Chief of this journal.

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Ogawa, D., Miyata, T., Yumoto, S. et al. Prognostic value of preoperative geriatric nutritional risk index in intrahepatic cholangiocarcinoma after hepatectomy: a single‑center retrospective cohort study. Langenbecks Arch Surg 409, 47 (2024). https://doi.org/10.1007/s00423-023-03221-8

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