RESUMEN
Objective: To evaluate the prognostic value of the preoperative Geriatric Nutritional Risk Index (GNRI) in patients with esophageal squamous cell carcinoma after radical resection. Methods: Clinicopathological and laboratory data of 315 elderly patients with esophageal squamous cell carcinoma who were older than 60 years and underwent radical resection in Tianjin Medical University Cancer Institute and Hospital from January 2008 to December 2012 were retrospectively analyzed. The GNRI formula was as follows:1.489×serum albumin (g/L)+41.7×(current body weight/ideal body weight). According to the GNRI, patients were divided into the normal and abnormal GNRI groups. The χ2 test was used to analyze the relationship between the GNRI and the clinicopathological char-acteristics of patients. The Kaplan-Meier method was used to analyze the survival rate, and survival analysis was conducted using the Log-rank test. Multivariate survival analysis was conducted using the Cox proportional risk regression model. Results: There were 259 patients in the normal GNRI group (GNRI>98) and 56 patients in the abnormal GNRI group (GNRI≤98). The GNRI was closely correlated with age, tumor location, tumor diameter, serum albumin level, body mass index (BMI), and lymph node metastasis (all P<0.05). The 5-year survival rates in the normal and abnormal GNRI groups were 41.2% and 27.0%, respectively, with statistical significance (P=0.002). Univariate analysis showed that age, tumor diameter, serum albumin level, BMI, GNRI, platelet-lymphocyte ratio, tumor invasion depth, and lymph node metastasis were risk factors for the prognosis of patients with esophageal squamous cell carcinoma (all P<0.05). Multivariate analysis showed that the preoperative GNRI (hazard ratio=0.687, 95% confidence interval: 0.487-0.968, P=0.032) was an independent factor affecting the prognosis of patients with esophageal squamous cell carcinoma. Subgroup analysis showed that the survival rates in the normal GNRI group were significantly higher than those in the abnormal GNRI group (P=0.036 and 0.010, respectively), regardless of lymph node metastasis. Conclusions: The preoperative GNRI is associated with malignant biological behav-ior in elderly patients with esophageal squamous cell carcinoma and can be used as a useful indicator for predicting survival after radi-cal resection.
RESUMEN
Background: In Maharashtra the elderly population is 9.9 % of the total state population (Census 2011). There is a need to highlight the nutritional problems being faced by the elderly in India. Early detection of malnutrition and timely interventions can help to reduce morbidity in the long run. Aims &Objectives: To find the prevalence of malnutrition in elderly and compare nutritional status of elderly residing in an urban area and urban slum. Material & Methods: This was a cross sectional hospital-based study. Data was collected from the civil OPD and ex-service men OPD of the hospital each having a catchment population from urban slum and urban area respectively. A total of 331 patients > 60 years of age were included. Nutritional status was assessed using the MNA, MUST and GNRI. Serum albumin levels were measured using colorimetric method. Results: The overall prevalence of malnutrition and at risk as per MNA score was 168 (50.7%). Out of 331 subjects, 209 belonged to urban slums and remaining 122 were from urban area. The gender and age distribution were comparable in both groups. The mean BMI of subjects from slum area was significantly lower as compared to urban group (22.3+ 5.3 vs 26.3+ 4.5) p<0.001. Proportion of elderly who had MNA score below 24 was significantly higher in the slum area (p<0.05). Proportion of elderly with mid arm circumference and calf circumference below the cut off of 22 cm and 31 cm respectively was significantly higher in slum area (p<0.05). Serum albumin levels were comparable in both groups. Mean BMI of elderly in urban area was >25Kg/m2. Conclusion: The overall prevalence of malnutrition was high. The nutritional status of elderly in urban slum was significantly worse than that of elderly in urban area.