To evaluate the prognostic value of preoperative geriatric nutritional risk index (GNRI) and pan-immune-inflammation value (PIV), individually and in combination, for overall survival (OS), recurrence-free survival (RFS), and two-year recurrence rates in this specific population. GNRI and PIV were calculated from preoperative laboratory data. Optimal cutoffs were determined by ROC analysis for 3-year OS. The associations with clinicopathological features and survival outcomes (OS, RFS, 2-year recurrence) were assessed. Independent prognostic factors were identified using multivariate Cox regression. The prognostic performance of the combined GNRI - PIV model was evaluated using time-dependent ROC analysis. Low GNRI (< 97.8) and high PIV (≥ 292.3) were significantly associated with advanced FIGO stage, higher tumor grade, lymph node metastasis, and increased two-year recurrence rates (all P < 0.05). Multivariate analysis confirmed both low GNRI (OS: 95% CI: 1.58–3.70, HR = 2.42, P < 0.001; RFS: 95% CI: 1.43–3.24, HR = 2.15,P < 0.001) and high PIV (OS: 95% CI: 1.43–3.32, HR = 2.18, P < 0.001; RFS: 95% CI: 1.30–2.90, HR = 1.94, P = 0.001) as independent predictors of poorer survival. The combination of GNRI and PIV demonstrated superior prognostic performance for 3-year OS (AUC = 0.81) and RFS (AUC = 0.78) compared to either marker alone. Patients with low GNRI/high PIV had the worst 2-year recurrence rate (65.8%), while those with high GNRI/low PIV and high GNRI/high PIV had significantly lower rates (9.6% and 3.1%, respectively) and superior OS and RFS compared to other groups (P < 0.001). Low GNRI (< 97.8) and high PIV (≥ 292.3) were significantly associated with advanced FIGO stage, higher tumor grade, lymph node metastasis, and increased two-year recurrence rates. Preoperative GNRI and PIV are potent, cost-effective, and independent prognostic biomarkers in elderly EC patients undergoing radical surgery. Their combination provides superior risk stratification for OS, RFS, and early recurrence, potentially guiding personalized adjuvant treatment and follow-up strategies.
Zhou et al. (Thu,) studied this question.