Impact of prognostic nutritional index and geriatric nutritional risk index on prognosis in elderly patients with early-stage prostate cancer.

[AIM] Prostate cancer predominantly affects older men and generally has a favorable early-stage prognosis, yet the prognostic significance of nutritional and inflammatory status remains uncertain. This study evaluated the prognostic value of the Prognostic Nutritional Index (PNI) and Geriatric Nutritional Risk Index (GNRI) in elderly patients with localized prostate cancer.

[METHODS] This single-center retrospective cohort study included 205 patients aged ≥65 years with early-stage prostate cancer treated between 2018 and 2024. Nutritional status was assessed at baseline using serum albumin, lymphocyte count, and body weight to calculate the PNI and GNRI. Overall survival was analyzed using standard survival analysis methods. All statistical analyses were performed using SPSS software version 26.0.

[RESULTS] The median patient age was 72 years. Of all patients, 41% were 75 years or older. Survival analysis showed that patients with low PNI had a median OS of 78 months. Those with high PNI had a median OS of 115 months ( = 0.008). Low GNRI was linked to a median survival of 74 months. High GNRI was linked to 120 months ( = 0.009). Higher Gleason score (≥8), higher PSA (≥10 ng/mL), older age (≥75 years), and clinical T2 disease were associated with worse outcomes. By contrast, radiotherapy improved survival (122 vs. 94 months, = 0.008). In multivariate analysis, low PNI, low GNRI, high Gleason score, and high PSA remained independent predictors.

[CONCLUSIONS] The PNI and GNRI serve as practical and accessible indicators of nutritional status and inflammation, thereby improving prognostic assessment and risk stratification in older patients with early-stage prostate cancer.