Modified geriatric nutritional risk index as a prognostic indicator for patients with intrahepatic cholangiocarcinoma undergoing liver resection

Background The modified Geriatric Nutritional Risk Index (mGNRI), which incorporates C-reactive protein (CRP) level and ideal body weight ratio, has been proposed as a prognostic indicator for survival in certain cancers. This study evaluated its association with outcomes in patients with intrahepatic cholangiocarcinoma (ICC) undergoing hepatectomy. Methods We retrospectively analyzed 99 patients with ICC who underwent hepatectomy between April 2008 and August 2022. The optimal mGNRI cut-off (88.2) determined by receiver-operating characteristic (ROC) curve analysis, classified patients into low and high mGNRI groups. Results Forty-five patients (45.5%) were in the low mGNRI group, and 54 (54.5%) were in the high mGNRI group. The low mGNRI group had a significantly lower body mass index (BMI) and hemoglobin and serum albumin levels, but higher CRP levels compared with the high mGNRI group. Recurrence-free survival (RFS; hazard ratio [HR]: 2.09, 95% confidence interval [CI]: 1.29–3.39, p = 0.003) and overall survival (OS; HR: 2.25, 95% CI: 1.32–3.83, p = 0.003) were both worse in the low mGNRI group than in the high mGNRI group. Multivariate Cox proportional hazards analysis showed that a low mGNRI was an independent prognostic factor for OS (HR: 1.86, 95% CI: 1.03–3.37, p = 0.041). Postoperative dietary intake was significantly lower in the low vs. the high mGNRI group. Conclusions The mGNRI has a prognostic impact on patients with ICC after hepatectomy. Patients with a low mGNRI showed poorer survival and a lower postoperative oral energy adequacy ratio, highlighting the importance of perioperative nutritional assessment in this population.