Significance of the geriatric nutrition risk index (GNRI) in colorectal cancer surgery patients

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Background:Japan’s aging population presents significant healthcare challenges, particularly in colorectal cancer care, where nutritional assessment is vital for improving outcomes. This study evaluated the prognostic value of the geriatric nutritional risk index (GNRI) in patients undergoing curative colorectal cancer surgery. Methods:We retrospectively analyzed 113 patients with stage II / III colorectal cancer who underwent curative surgery. Patients were categorized into GNRI Low (≤ 92) and High (> 92) groups. Clinicopathological characteristics, immunonutritional indicators, postoperative complications, and survival outcomes were compared. Results:The GNRI Low group (24.8%) had significantly older age, lower BMI, poorer ASA classification, frailty, and larger tumor size compared with the GNRI High group. Immunonutritional indicators, including albumin, CRP, NLR, and PNI, were also worse in the GNRI Low group. However, no significant difference in perioperative complications was observed between the groups. Five-year OS was 76.0% in GNRI Low versus 89.2% in GNRI High (p = 0.05), and 5-year DFS was 53.8% versus 74.2% (p = 0.04). Conclusion:Low GNRI was associated with poor prognosis in colorectal cancer patients, despite no increase in surgical complications. Preoperative nutritional assessment using GNRI may help identify high-risk patients and support targeted interventions. J. Med. Invest. 73 : 101-105, February, 2026