Clinical value of geriatric nutritional risk index and pan-immune-inflammation value in locally advanced gastric cancer receiving neoadjuvant chemotherapy

doi:10.4251/wjgo.v18.i2.115387

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World Journal of Gastrointestinal Oncology

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastrointest Oncol. Feb 15, 2026; 18(2): 115387
Published online Feb 15, 2026. doi: 10.4251/wjgo.v18.i2.115387

Clinical value of geriatric nutritional risk index and pan-immune-inflammation value in locally advanced gastric cancer receiving neoadjuvant chemotherapy

Wen-Tao Zhong, Shi-Kang Ding, Ru-Yin Li, Cheng-Yu Liu, Hong-Yun Huang, Jian-Chun Yu

Wen-Tao Zhong, Shi-Kang Ding, Ru-Yin Li, Cheng-Yu Liu, Hong-Yun Huang, Jian-Chun Yu, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China

Author contributions: Zhong WT, Ding SK, Li RY, Liu CY, and Huang HY performed research; Zhong WT and Yu JC designed this research, analyzed data and wrote the paper. All authors contributed to editorial changes in the manuscript, read and approved the final manuscript.

Supported by the National Key Research and Development Program of China, No. 2022YFF1100400.

Institutional review board statement: This retrospective study was approved by the Ethics Committee of the Peking Union Medical College Hospital (Approval No. I-25PJ0504). This study was performed in accordance with the guidelines of the Helsinki Declaration.

Informed consent statement: The need for patient consent was waived due to the retrospective nature of the study.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Data sharing statement: Data are available from correspondence upon reasonable request.

Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Jian-Chun Yu, MD, Professor, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, No. 9 Dongdan Third Lane, Dongcheng District, Beijing 100730, China. yu-jch@163.com

Received: October 17, 2025
Revised: November 13, 2025
Accepted: December 18, 2025
Published online: February 15, 2026
Processing time: 110 Days and 18.3 Hours

Abstract

BACKGROUND

Metabolism and nutrition status play an important role in the development of cancer. However, whether inflammation and malnutrition related indicators can predict the efficacy of neoadjuvant chemotherapy (NACT) and the prognosis of gastric cancer has not been addressed.

AIM

To evaluate the predictive value of malnutrition as determined by the geriatric nutritional risk index (GNRI) and inflammation represented by the pan-immune-inflammation value (PIV) for the response to NACT patients’ prognosis in locally advanced gastric cancer (LAGC).

METHODS

We retrospectively analyzed 147 LAGC patients who underwent radical resection after NACT. The PIV, and GNRI were compared according to whether receiving nutritional intervention during NACT. The prognostic values of GNRI and PIV were assessed using time-dependent receiver operating characteristic curve analysis, log-rank tests, and Cox regression analysis.

RESULTS

Nutritional intervention could improve nutrition status and reduce inflammation during NACT in LAGC patients. Multivariate analysis showed that GNRI (hazard ratio = 0.956, 95% confidence interval: 0.923-0.991, P = 0.013), PIV (hazard ratio = 1.002, 95% confidence interval: 1-1.005, P = 0.041) were independent predictors for OS. Significant differences of overall survival and disease-free survival according to GNRI (P < 0.001) and PIV (P < 0.001) were observed between the low and high groups. The GNRI-PIV score constructed with GNRI and PIV had a higher area under the curve and was significantly associated with pathological tumor regression response.

CONCLUSION

GNRI and PIV are useful predictive biomarkers in patients with LAGC receiving NACT, and nutritional supplement can improve patients’ status. The GNRI-PIV score may contribute to a more personalized and holistic approach for LAGC patients underwent NACT.

Keywords: Prognosis; Neoadjuvant chemotherapy; Locally advanced gastric cancer; Pan-immune-inflammation value; Geriatric nutritional risk index

Core Tip: This is a retrospective single-center observational study to investigate the value of geriatric nutritional risk index and pan-immune-inflammation value in locally advanced gastric cancer patients. We found that the geriatric nutritional risk index and pan-immune-inflammation value serve as prognostic indictors that reflects nutrition and inflammation status and predict the response to neoadjuvant therapy in locally advanced gastric cancer. Additionally, the results also emphasized the necessity of nutritional support during neoadjuvant therapy for patients.