Malnutrition is associated with prognosis in cancer. The geriatric nutritional risk index (GNRI), based on the ratio of actual to ideal body weight and also serum albumin level, is a simple screening tool for assessing nutrition. We investigated the GNRI as a prognostic factor for oncological outcomes in patients with high-risk metastatic hormone-sensitive prostate cancer (mHSPC) using a Japanese multicenter cohort. This study included a total of 175 patients with LATITUDE high-risk mHSPC, of whom 102 had received androgen deprivation therapy (ADT) plus upfront abiraterone acetate, and 73 had received ADT plus bicalutamide (Bica), from 14 institutions associated with the Tokai Urologic Oncology Research Seminar. Patients were classified into GNRI-low (<98) or GNRI-high (≥98) groups. The GNRI was based on the body mass index and serum albumin level. Kaplan–Meier analysis revealed that the median overall survival (OS) of a GNRI-low group (median 33.7 months; 95% confidence interval [CI]: 26.2–not reached [NR]) was significantly worse than that of a GNRI-high group (median: NR; 95% CI: NR–NR;p< 0.001). Multivariate analysis identified Bica and low GNRI (<98) as independent prognostic factors for reduced times to both castration-resistant prostate cancer and OS, and, therefore, a poor prognosis. Our findings indicate the GNRI may be a practical prognostic indicator in the evaluation of survival outcomes in patients with LATITUDE high-risk mHSPC.
营养不良与癌症预后相关。老年营养风险指数（GNRI）基于实际体重与理想体重比值及血清白蛋白水平，是一种简便的营养评估筛查工具。本研究利用日本多中心队列数据，探讨GNRI作为高危转移性激素敏感性前列腺癌（mHSPC）患者肿瘤学结局预后因素的价值。研究纳入来自东海泌尿肿瘤研究研讨会14家机构的175例LATITUDE标准高危mHSPC患者，其中102例接受雄激素剥夺疗法（ADT）联合前期醋酸阿比特龙治疗，73例接受ADT联合比卡鲁胺治疗。根据体重指数和血清白蛋白水平计算GNRI，将患者分为GNRI低值组（<98）与GNRI高值组（≥98）。Kaplan-Meier分析显示，GNRI低值组中位总生存期（33.7个月；95%置信区间[CI]：26.2-未达到[NR]）显著差于GNRI高值组（中位值：NR；95% CI：NR-NR；p<0.001）。多变量分析证实比卡鲁胺治疗和低GNRI（<98）是去势抵抗性前列腺癌转化时间与总生存期缩短的独立预后因素，提示不良预后。本研究结果表明，GNRI可作为评估LATITUDE高危mHSPC患者生存结局的实用预后指标。
肿瘤(癌症)患者之家