The Global Immune-Nutrition-Information Index (GINI) Is an Independent Prognostic Factor for Esophageal Cancer Patients Who Receive Curative Treatment

Background/aim: The aim of the present study was to evaluate the clinical impact of the Global Immune-Nutrition-Information Index (GINI) in patients with esophageal cancer (EC) who received curative treatment and to clarify the potential of the GINI as a prognostic factor.

Patients and methods: Patients who underwent curative resection for EC at Yokohama City University between 2000 and 2020 were consecutively chosen based on their medical records. The GINI was defined as follows: GINI=[C-reactive protein×platelet×monocyte×neutrophil]/[albumin×lymphocyte].

Results: This study included 180 patients. Among them, 67 were categorized into the GINI-low group and 113 were categorized into the GINI-high group, with a cutoff value of 5000. The 3- and 5- year overall survival (OS) rates were 75.6% and 64.9%, respectively, in the GINI-low group and 55.3% and 48.1% in the GINI-high group (p=0.005). According to a multivariate analysis for OS, the GINI was identified as an independent prognostic factor [hazard ratio=2.106, 95% confidence interval=1.252-3.544, p=0.005]. Similar results were observed for RFS. In addition, the GINI affects preoperative tube feeding and the induction rate of neoadjuvant chemotherapy (NAC).

Conclusion: The GINI is a promising biomarker for the treatment and management of EC.