Geriatric Nutritional Risk Index Predicts Treatment Intolerance and Survival in Head and Neck Cancer.

Area of Science:

• Oncology
• Geriatrics
• Surgical Oncology

Background:

• Malnutrition is a known predictor of adverse outcomes in head and neck cancer (HNC) patients.
• The Geriatric Nutritional Risk Index (GNRI) is a potential tool for assessing nutritional status and predicting outcomes, but its specific role in HNC requires further investigation.

Purpose of the Study:

• To evaluate the predictive value of the preoperative Geriatric Nutritional Risk Index (GNRI) for postoperative morbidity, mortality, and survival in patients undergoing surgery for head and neck cancer (HNC).

Main Methods:

• An ambispective study included 312 treatment-naïve patients undergoing HNC surgery across two academic centers from 2015 to 2024.
• Preoperative GNRI scores were categorized into moderate-to-high risk (<92), low risk (92-98), and no risk (>98).
• Outcomes assessed included 90-day mortality, treatment intolerance, overall survival, and disease-free survival, with analyses adjusted for relevant clinical and demographic factors.

Main Results:

• Patients with moderate-to-high GNRI risk (13%) experienced higher rates of major adverse events (57% vs. 36%) and treatment intolerance (61% vs. 41%) compared to those with no risk.
• Multivariable analysis revealed that moderate-to-high GNRI risk was significantly associated with increased odds of 90-day mortality (OR 2.99) and treatment intolerance (OR 2.35).
• Cox regression demonstrated that a lower GNRI score predicted significantly shorter overall survival (HR 2.28) and disease-free survival (HR 1.87).

Conclusions:

• The preoperative Geriatric Nutritional Risk Index (GNRI) is a valuable tool for predicting treatment intolerance and poorer survival outcomes in patients with operable head and neck cancer (HNC).
• Incorporating GNRI assessment into preoperative evaluations may aid in identifying high-risk HNC patients who could benefit from targeted nutritional interventions.