S-1 adjuvant chemotherapy (AC) is the standard treatment for pancreatic ductal adenocarcinoma (PDAC) after curative surgery in Japan. Our prior research suggested that a lower postoperative geriatric nutritional risk index (GNRI) predicts S-1 discontinuation due to adverse events (AEs). This study aimed to validate the GNRI as a predictor of S-1 non-completion using an independent cohort.Methods:This retrospective study analyzed 180 patients who underwent curative PDAC resection at Dokkyo Medical University from January 2010 to March 2023. Postoperative GNRI values were recorded as part of nutritional screening. Data on S-1 therapy completion and related clinical factors were analyzed statistically.Results:Patients were classified based on S-1 completion (N= 93) and non-completion (N= 48). GNRI values were significantly lower in the non-completion group. A GNRI threshold of 94.4, identified in a prior study, effectively distinguished patients at risk of discontinuation. Univariate analysis confirmed that a GNRI of ≥94.4 was a significant predictor of successful S-1 completion [hazard ratio (HR) for recurrence-free survival (RFS), 1.54; 95% confidence interval (CI) 1.04–2.28 and for overall survival (OS), 1.89; 95% CI 1.20–2.99].Conclusions:This study validated previous findings, confirming that the postoperative GNRI reliably identifies patients at risk of S-1 non-completion due to AEs after PDAC surgery. The GNRI serves as a practical marker for optimizing patient care and enhancing AC efficacy.
在日本，S-1辅助化疗是胰腺导管腺癌根治性手术后的标准治疗方案。我们先前的研究表明，术后老年营养风险指数较低可预测因不良事件导致的S-1治疗中断。本研究旨在通过独立队列验证GNRI作为S-1治疗未完成预测指标的有效性。 方法：本回顾性研究分析了2010年1月至2023年3月期间在独协医科大学接受根治性PDAC切除术的180例患者。术后GNRI值作为营养筛查指标被记录。对S-1治疗完成情况及相关临床因素进行统计学分析。 结果：根据S-1治疗完成情况将患者分为完成组（93例）与未完成组（48例）。未完成组的GNRI值显著较低。前期研究确定的GNRI临界值94.4能有效区分存在治疗中断风险的患者。单因素分析证实，GNRI≥94.4是S-1成功完成的重要预测指标[无复发生存期的风险比为1.54（95%置信区间1.04-2.28），总生存期的风险比为1.89（95%置信区间1.20-2.99）]。 结论：本研究验证了既往发现，证实术后GNRI能可靠识别PDAC术后因不良事件导致S-1治疗未完成的高风险患者。GNRI可作为优化患者管理、提升辅助化疗疗效的实用指标。
肿瘤(癌症)患者之家