Presentation Authors: Teppei Okamoto*, Shingo Hatakeyama, Hirosaki, Japan, Shintaro Narita, Akita, Japan, Masahiro Takahashi, Sendai, Japan, Toshihiko Sakurai, Yamagata, Japan, Sadafumi Kawamura, Sendai, Japan, Senji Hoshi, Yamagata, Japan, Masanori Ishida, Isawa, Japan, Toshiaki Kawaguchi, Aomori, Japan, Shigeto Ishidoya, Sendai, Japan, Jiro Shimoda, Isawa, Japan, Hiromi Sato, Akita, Japan, Koji Mitsuzuka, Tatsuo Tochigi, Sendai, Japan, Norihiko Tsuchiya, Yamagata, Japan, Yoichi Arai, Sendai, Japan, Tomonori Habuchi, Akita, Japan, Chikara Ohyama, Hirosaki, Japan
Introduction: Nutritional status is suggested as a prognostic factor for some malignancies, however, its impact on patients with prostate cancer remains unknown. We investigated the association between Geriatric Nutritional Risk Index (GNRI) and prognosis in patients with newly diagnosed metastatic prostate cancer (mPC).
Methods: We retrospectively reviewed data within Michinoku Urological Cancer Study Group database containing of 667 patients with newly diagnosed mPC who were initially treated with androgen-deprivation therapy from 2008 to 2017. Of those, 324 patients who had adequate information were analyzed. GNRI at diagnosis was calculated using serum albumin and body mass index. Malnutrition was defined as GNRI of < 98.0. Metastatic tumor burden was assessed using CHAARTED risk criteria. The characteristics, cancer-specific survival (CSS), overall survival (OS), and castration resistant prostate cancer (CRPC)-free survival were compared between the two groups; the malnutrition (GNRI < 98.0) and non-malnutrition (GNRI â‰¥98.0) groups. The independent prognostic factors for clinical outcomes were investigated using Cox proportional hazards regression analyses.
Results: Median age, GNRI, and follow-up period were 72 years, 101.2, and 25 months, respectively. Of 324 patients, 126 (39%) patients were diagnosed with malnutrition (GNRI < 98.0). Patients with malnutrition had a significant poorer CSS, OS (P < 0.001), and CRPC-free survival (P=0.004). Multivariate Cox proportional hazards regression analyses demonstrated that a GNRI < 98.0 was an independent prognostic factor for CSS [hazard ratio (HR), 1.64; 95% confidence interval (CI); 1.02-2.62, P=0.039] and OS (HR, 1.89; 95% CI, 1.25-2.87, P=0.003), but not for CRPC-free survival.
Conclusions: The GNRI is considered to be a useful prognostic factor for mortality in patients with newly diagnosed mPC.