A Comparison of the Predictive Role of the Geriatric Nutritional Risk Index and Immunonutritional Parameters for Postoperative Complications in Elderly Patients with Renal Cell Carcinoma.

Background: The geriatric nutritional risk index (GNRI) is reportedly a useful factor for predicting postoperative complications in elderly patients with several cancers. The aim of this study was to investigate the relationship between postoperative complications and the GNRI in elderly patients with renal cell carcinoma (RCC). Materials and Methods: The clinical data of 62 patients who were ≥65 years old and underwent open surgery for RCC were analyzed retrospectively. The American Society of Anesthesiologists physical status, Charlson comorbidity index, surgical procedure, body mass index, GNRI, platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), psoas muscle index (PMI), visceral fat area, and subcutaneous fat area were examined. The association of the GNRI and immunonutritional parameters with postoperative complications was analyzed by the univariate and multivariate analyses.Results: Grade ≥ II postoperative complications evaluated by the Clavien-Dindo classification were seen in 11 out of 62 cases. In the Spearman's correlation test, the GNRI showed a significant negative correlation with the PLR and NLR and a significant positive correlation with the PMI. The group with postoperative complications showed a significantly lower GNRI, higher PLR, and higher NLR than those without complications. In the multivariate analysis, a GNRI ≤92 was independently associated with postoperative complications.Conclusion: The GNRI might play an important role in evaluation of the risk of postoperative complications in open surgery for elderly RCC patients.

Journal of investigative surgery : the official journal of the Academy of Surgical Research. 2020 May 13 [Epub ahead of print]

Daisuke Watanabe, Kunihisa Miura, Akemi Yamashita, Tadaaki Minowa, Yuko Uehara, Shinobu Mizushima, Seiichiro Yoshikawa, Akio Mizushima

Department of Palliative Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan., Department of Anesthesiology and Pain Medicine, Koto Hospital, Tokyo, Japan., Department of Urology, Koto Hospital, Tokyo, Japan., Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan., Cancer Therapeutic Center, Juntendo University Urayasu Hospital, Chiba, Japan.