The prognostic importance of the global immune-nutrition-information index (GINI) in patients with Ras wild type metastatic colorectal cancer

Abstract In this study, we aimed to evaluate the clinical impact of the Global Immune-Nutrition Information Index (GINI) in patients with Ras wild-type metastatic colorectal cancer (mCRC) who received first-line palliative chemotherapy Ras wild-type mCRC. We retrospectively reviewed 177 patients dia...

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Main Authors: Oktay Bozkurt, Rıdvan Gönül, Bugra Umut Kaya, Gozde Erturk Zararsiz, Mevlüde İnanc, Metin Özkan
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Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-11148-x
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author Oktay Bozkurt
Rıdvan Gönül
Bugra Umut Kaya
Gozde Erturk Zararsiz
Mevlüde İnanc
Metin Özkan
author_facet Oktay Bozkurt
Rıdvan Gönül
Bugra Umut Kaya
Gozde Erturk Zararsiz
Mevlüde İnanc
Metin Özkan
author_sort Oktay Bozkurt
collection DOAJ
description Abstract In this study, we aimed to evaluate the clinical impact of the Global Immune-Nutrition Information Index (GINI) in patients with Ras wild-type metastatic colorectal cancer (mCRC) who received first-line palliative chemotherapy Ras wild-type mCRC. We retrospectively reviewed 177 patients diagnosed with Ras Wild Type mCRC between March 2009 and December 2023. The GINI was defined as follows: GINI= [C-reactive protein×platelet×monocyte×neutrophil]/[albumin×lymphocyte]. According to threshold values determined by receiver operating characteristics (ROC) analysis, the GINI was divided into two groups with < 2000 and ≥ 2000. Survival probabilities were predicted with the Kaplan-Meier method and group comparisons were applied with the Log-rank test. Furthermore, univariate and multiple Cox regression analyses were used to determine the most substantial risk elements. Median progression-free survival (PFS) 15 months in the group with GINI ≥ 2000 (95% Confidence interval (CI): 10.5–19.48) and 27 months (95% CI: 17.5–36.4) in the group with GINI < 2000 (p = 0.00021). The median OS was 27 months (95% CI: 23.8–30.1) in the GINI ≥ 2000 group and 77 months (95% CI: 59.7–94.2) in the GINI < 2000 group (p < 0.001). The results of multivariate analysis for PFS showed that albumin (HR, 1.83, p = 0.009), and prechemotherapy GINI (HR 1.79, p = 0.004) were significant independent prognostic factors. The results of multivariate analysis for OS showed that performance status (HR, 1.65; p = 0.018), number of metastatic sites (HR, 1.74, 0.005), skin toxicity (HR, 1.79, p = 0.003), pre-chemotherapy NLR (HR, 1.49, p = 0.045) and prechemotherapy GINI (HR 3.25, p < 0.001) were significant independent prognostic factors. Higher GINI values were associated with worse survival outcomes in patients with RAS wild-type mCRC, supporting its potential clinical use as a prognostic biomarker.
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spelling doaj-art-b665571b36e449bf85426883e16eb2fc2025-08-20T03:04:29ZengNature PortfolioScientific Reports2045-23222025-07-0115111110.1038/s41598-025-11148-xThe prognostic importance of the global immune-nutrition-information index (GINI) in patients with Ras wild type metastatic colorectal cancerOktay Bozkurt0Rıdvan Gönül1Bugra Umut Kaya2Gozde Erturk Zararsiz3Mevlüde İnanc4Metin Özkan5Department of Medical Oncology, Erciyes University Faculty of MedicineDepartment of Medical Oncology, Erciyes University Faculty of MedicineDepartment of Internal Medicine, Erciyes University Faculty of MedicineDepartment of Biostatistics, Erciyes University School of MedicineDepartment of Medical Oncology, Erciyes University Faculty of MedicineDepartment of Medical Oncology, Erciyes University Faculty of MedicineAbstract In this study, we aimed to evaluate the clinical impact of the Global Immune-Nutrition Information Index (GINI) in patients with Ras wild-type metastatic colorectal cancer (mCRC) who received first-line palliative chemotherapy Ras wild-type mCRC. We retrospectively reviewed 177 patients diagnosed with Ras Wild Type mCRC between March 2009 and December 2023. The GINI was defined as follows: GINI= [C-reactive protein×platelet×monocyte×neutrophil]/[albumin×lymphocyte]. According to threshold values determined by receiver operating characteristics (ROC) analysis, the GINI was divided into two groups with < 2000 and ≥ 2000. Survival probabilities were predicted with the Kaplan-Meier method and group comparisons were applied with the Log-rank test. Furthermore, univariate and multiple Cox regression analyses were used to determine the most substantial risk elements. Median progression-free survival (PFS) 15 months in the group with GINI ≥ 2000 (95% Confidence interval (CI): 10.5–19.48) and 27 months (95% CI: 17.5–36.4) in the group with GINI < 2000 (p = 0.00021). The median OS was 27 months (95% CI: 23.8–30.1) in the GINI ≥ 2000 group and 77 months (95% CI: 59.7–94.2) in the GINI < 2000 group (p < 0.001). The results of multivariate analysis for PFS showed that albumin (HR, 1.83, p = 0.009), and prechemotherapy GINI (HR 1.79, p = 0.004) were significant independent prognostic factors. The results of multivariate analysis for OS showed that performance status (HR, 1.65; p = 0.018), number of metastatic sites (HR, 1.74, 0.005), skin toxicity (HR, 1.79, p = 0.003), pre-chemotherapy NLR (HR, 1.49, p = 0.045) and prechemotherapy GINI (HR 3.25, p < 0.001) were significant independent prognostic factors. Higher GINI values were associated with worse survival outcomes in patients with RAS wild-type mCRC, supporting its potential clinical use as a prognostic biomarker.https://doi.org/10.1038/s41598-025-11148-xGINIColorectal cancerPrognosis
spellingShingle Oktay Bozkurt
Rıdvan Gönül
Bugra Umut Kaya
Gozde Erturk Zararsiz
Mevlüde İnanc
Metin Özkan
The prognostic importance of the global immune-nutrition-information index (GINI) in patients with Ras wild type metastatic colorectal cancer
Scientific Reports
GINI
Colorectal cancer
Prognosis
title The prognostic importance of the global immune-nutrition-information index (GINI) in patients with Ras wild type metastatic colorectal cancer
title_full The prognostic importance of the global immune-nutrition-information index (GINI) in patients with Ras wild type metastatic colorectal cancer
title_fullStr The prognostic importance of the global immune-nutrition-information index (GINI) in patients with Ras wild type metastatic colorectal cancer
title_full_unstemmed The prognostic importance of the global immune-nutrition-information index (GINI) in patients with Ras wild type metastatic colorectal cancer
title_short The prognostic importance of the global immune-nutrition-information index (GINI) in patients with Ras wild type metastatic colorectal cancer
title_sort prognostic importance of the global immune nutrition information index gini in patients with ras wild type metastatic colorectal cancer
topic GINI
Colorectal cancer
Prognosis
url https://doi.org/10.1038/s41598-025-11148-x
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