Geriatric nutritional risk index and prognosis in middle-aged and elderly patients with nasopharyngeal carcinoma

Abstract

To evaluate the prognostic value of the pretreatment Geriatric Nutritional Risk Index (GNRI) in middle-aged and older patients with nasopharyngeal carcinoma (NPC). This study included 235 patients with NPC aged ≥ 50 years. Patients were stratified into low GNRI (GNRI ≤ 98) and high GNRI (GNRI > 98) groups. The clinical characteristics were compared using the chi-square test. Survival outcomes were analyzed using Kaplan–Meier curves, log-rank tests, and Cox proportional hazards models. Of the 235 patients included in the study, 110 (46.8%) were in the low GNRI group. During a median follow-up of 70 months, patients in the high GNRI group had significantly better overall survival (OS) and event-free survival (EFS) than those with ( p < 0.05). Lower body mass index and serum albumin levels were independently associated with low GNRI. Multivariate analysis confirmed that low GNRI was an independent predictor of poorer OS (HR = 1.802, 95% CI: 1.122–2.894, p = 0.015) and EFS (HR = 1.694, 95% CI: 1.080–2.657, p = 0.022). No significant interactions were observed between GNRI and other variables ( p > 0.05). Pretreatment GNRI independently predicts survival in middle-aged and elderly patients with NPC. A low GNRI identifies patients at higher risk of poor outcomes and may help guide prognostic evaluations and supportive care strategies.