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Link to original content: http://pubmed.ncbi.nlm.nih.gov/38839809/
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. 2024 Jun 5;14(1):12921.
doi: 10.1038/s41598-024-63671-y.

Prognostic importance of modified geriatric nutritional risk index in oral cavity squamous cell carcinoma

Yao-Te Tsai  1   2 , Ming-Hsien Tsai  2   3 , Geng-He Chang  1   2 , Ming-Shao Tsai  1   2 , Ethan I Huang  1   2 , Chang-Hsien Lu  2   4 , Cheng-Ming Hsu  1   2 , Chia-Hsuan Lai  2   5 , Chun-Ta Liao  2   6 , Chung-Jan Kang  2   6 , Yi-Chan Lee  2   7 , Yuan-Hsiung Tsai  2   8 , Ku-Hao Fang  9   10   11
Affiliations

Prognostic importance of modified geriatric nutritional risk index in oral cavity squamous cell carcinoma

Yao-Te Tsai et al. Sci Rep. .

Abstract

We probed the associations of preoperative modified geriatric nutritional risk index (mGNRI) values with prognosis in patients receiving surgery for oral cavity squamous cell carcinoma (OCSCC). This retrospective study analyzed the clinical data of 333 patients with OCSCC and undergoing surgery between 2008 and 2017. The preoperative mGNRI was calculated using the following formula: (14.89/C-reactive protein level) + 41.7 × (actual body weight/ideal body weight). We executed receiver operating characteristic curve analyses to derive the optimal mGNRI cutoff and employed Kaplan-Meier survival curves and Cox proportional hazard model to probe the associations of the mGNRI with overall survival (OS) and disease-free survival (DFS). The optimal mGNRI cutoff was derived to be 73.3. We noted the 5-year OS and DFS rates to be significantly higher in the high-mGNRI group than in the low-mGNRI group (both p < 0.001). A preoperative mGNRI below 73.3 was independently associated with unfavorable DFS and OS. A mGNRI-based nomogram was constructed to provide accurate OS predictions (concordance index, 0.781). Hence, preoperative mGNRI is a valuable and cost-effective prognostic biomarker in patients with OCSCC. Our nomogram facilitates the practical use of mGNRI and offers individualized predictions of OS.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Cutoff value of mGNRI derived from receiver operating characteristic curve analysis. AUC area under the curve, mGNRI modified geriatric nutritional risk index.
Figure 2
Figure 2
Kaplan–Meier curves for (a) overall survival and (b) disease-free survival stratified by preoperative mGNRI. An mGNRI value of < 73.3 was significantly associated with unfavorable outcomes. mGNRI modified geriatric nutritional risk index.
Figure 3
Figure 3
Kaplan–Meier survival curves for samples stratified by the mGNRI and cancer stage revealed a correlation between poorer overall survival and an mGNRI of < 73.3 in patients with (a) stage I–II and (c) stage III–IV (both p < 0.001) disease. Similar results were observed for disease-free survival in patients with (d) stage III–IV disease (p = 0.001), but not in those with (b) stage I–II disease (p = 0.235). mGNRI modified geriatric nutritional risk index.
Figure 4
Figure 4
Stratified analysis examining the associations between the mGNRI and OS. A consistent trend was observed across all subgroups. CI confidence interval, DOI depth of invasion, ENE extranodal extension, HR Hazard ratio, mGNRI modified geriatric nutritional risk index, PNI perineural invasion.
Figure 5
Figure 5
Predictive nomogram. (a) Nomogram designed for predicting OS based on the mGNRI and the independent prognostic factors identified through multivariable analysis. The contribution of each variable’s risk level is indicated by the line segment and its corresponding points. The total points were calculated by summing the points for each variable. To determine the likelihood of 3-year and 5-year OS, a vertical line was drawn from the calculated total points. Calibration plots for (b) 3-year and (c) 5-year OS are displayed. The light gray line at a 45° angle represents perfect predictive accuracy, and the blue line represents the predictive outcomes of the nomogram. The nomogram’s performance, along with the 95% confidence intervals for OS predictions, is presented as blue dots with bars. LVI lymphovascular invasion, M-D moderate differentiation, mGNRI modified geriatric nutritional risk index, P-D poor differentiation, PNI perineural invasion, W-D well differentiation.
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