Predictive role of geriatric nutritional risk index for postoperative complications in operated esophageal cancer patients: a meta-analysis

Abstract Purpose To determine the association between preoperative geriatric nutritional risk index (GNRI) and postoperative complications in surgical esophageal cancer patients. Methods PubMed, Web of Science EMBASE and CNKI databases were searched from inception up to December 16, 2024. Primary outcome was the overall complication. Secondary outcomes included the postoperative pulmonary complication (PPC), anastomotic leakage, chylothorax, vocal code paresis, pneumonia, arrhythmia, incision infection, gastrointestinal complication, respiratory failure and heart failure. Odds ratios (ORs) and 95% confidence intervals (CIs) were combined. Results Eight eligible studies were included with 1,689 cases. Pooled results demonstrated that lower GNRI was significantly related to increased risk of overall complication (OR = 2.56, 95% CI: 1.85–3.55, P <0.001) and PPC (OR = 2.06, 95% CI: 1.71–2.48, P <0.001). Besides, GNRI was associated with the risk of anastomotic leakage (OR = 1.83, P = 0.007), pneumonia (OR = 3.87, P <0.001) and respiratory failure (OR = 9.71, P = 0.003). Conclusion Based on available evidence, GNRI could serve as a prognostic indicator and a lower GNRI predicted increased incidence of postoperative complications among surgical esophageal cancer patients. However, due to the limitations of this meta-analysis like the small sample size, more high-quality studies are still needed to verify above findings. Trial registration This meta-analysis was registered in INSPLAY platform (INPLASY202590012; DOI: https://doi.org/10.37766/inplasy2025.9.0012 ).