The Prognostic Implications of the Geriatric Nutritional Risk Index in Patients with Prostate Cancer: A Single-Center Retrospective Cohort Study.

Background and Aims: Nutritional risk is a significant yet often overlooked factor influencing postoperative outcomes in older patients with prostate cancer. This study aimed to evaluate the impact of the Geriatric Nutritional Risk Index (GNRI) on postoperative complications in older patients undergoing radical prostatectomy. Secondary objectives included examining the association between the GNRI and healthcare resource utilization, specifically the length of hospital stay and hospitalization costs. Methods: This retrospective cohort study included patients aged ≥ 65 years who underwent laparoscopic radical prostatectomy at a single tertiary center between 2022 and 2024. Patients were stratified into a malnutrition group (GNRI ≤ 98) and a normal nutrition group (GNRI > 98). Clinical outcomes were compared using chi-square and t tests. Binary logistic regression was performed to identify independent predictors of complications, hospital stay, and costs. Results: Of the 264 patients included, 34.8% were classified as being at nutritional risk. The malnutrition group had a significantly higher incidence of postoperative complications (OR = 2.859, p = 0.007), longer hospital stays (OR = 4.678, p < 0.001), and greater hospitalization costs (OR = 4.867, p < 0.001). Nutritional risk remained a significant predictor after adjusting for confounders. Conclusions: GNRI-defined nutritional risk is independently associated with increased postoperative complications and higher healthcare resource utilization in older prostate cancer patients. The GNRI may serve as a practical and accessible tool for perioperative risk stratification in this population.