Impact of malnutrition on cancer recurrence, colorectal cancer‐specific death, and non‐colorectal cancer‐related death in patients with colorectal cancer who underwent curative surgery

Abstract

AbstractAimThis study aimed to examine how malnutrition, as reflected by the Geriatric Nutritional Risk Index (GNRI), is associated with colorectal cancer (CRC) recurrence and cause of death.MethodsConsecutive stage I‐III CRC patients (n = 601) were divided into two groups using GNRI 98 as the cutoff. The relationship of GNRI with overall survival (OS) and recurrence‐free survival (RFS) was evaluated, followed by competing risk analysis to determine prognostic factors of non‐CRC‐related death, and hazard function analysis to examine changes in the risk of recurrence and death.ResultsMedian body mass index was lower in the low GNRI group than in the high GNRI group (19.8 vs. 23.5; p < 0.001). After adjusting for known prognostic factors, a low GNRI was independently associated with reduced OS/RFS, and was a significant predictor of non‐CRC‐related death. The risk of recurrence was higher and peaked earlier in the low GNRI group than in the high GNRI group, although after 3 years, both groups had a similar risk. Meanwhile, the low GNRI group had a higher risk of non‐CRC‐related death over the course of 5 years.ConclusionIt is important to consider preoperative nutritional status along with the cancer stage when developing strategies to improve outcomes for CRC patients.