Prognostic Relevance of Preoperative Immune, Inflammatory, and Nutritional Biomarkers in Patients Undergoing Gastrectomy for Resectable Gastric Adenocarcinoma: An Observational Multicentre Study

Other authors

Institut Català de la Salut

[Tur-Martínez J] Departament de Cirurgia, Universitat Autònoma de Barcelona, Bellaterra, Spain. Department of Surgery, Complex Hospitalari Universitari Moisès Broggi, Sant Joan Despí, Spain. [Rodríguez-Santiago J] Department of Surgery, University Hospital Mútua Terrassa, Terrassa, Spain. [Osorio J] Department of Surgery, Hospital Clínic de Barcelona, Barcelona, Spain. [Miró M] Department of Surgery, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain. [Yarnoz C] Department of Surgery, Hospital Universitario de Navarra, Universidad Pública de Navarra, Pamplona, Spain. [Jofra M] Servei de Cirurgia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Aldeano A] Department of Surgery, Hospital General de Granollers, Granollers, Spain

Vall d'Hebron Barcelona Hospital Campus

Publication date

2024-07-04T09:45:35Z

2024-07-04T09:45:35Z

2024-06-11



Abstract

Gastric cancer; Preoperative biomarker; Preoperative immune score


Cáncer gástrico; Biomarcador preoperatorio; Puntuación inmunológico preoperatorio


Càncer gàstric; Biomarcador preoperatori; Puntuació immunològica preoperatòria


Background: The aim of this study was to evaluate different preoperative immune, inflammatory, and nutritional scores and their best cut-off values as predictors of poorer overall survival (OS) and disease-free survival (DFS) in patients who underwent curative gastric cancer resection. Methods: This was a retrospective observational multicentre study based on data of the Spanish EURECCA Esophagogastric Cancer Registry. Time-dependent Youden index and log-rank test were used to obtain the best cut-offs of 18 preoperative biomarkers for OS and DFS. An adjusted Cox model with variables selected by bootstrapping was used to identify the best preoperative biomarkers, which were also analysed for every TNM stage. Results: High neutrophil-to-lymphocyte ratio (NLR), high monocyte systemic inflammation index (moSII), and low prognostic nutritional index (PNI) were identified as independent predictors of poor outcome: NLR > 5.91 (HR:1.73; 95%CI [1.23–2.43]), moSII >2027.12 (HR:2.26; 95%CI [1.36–3.78]), and PNI >40.31 (HR:0.75; 95%CI [0.58–0.96]) for 5-year OS and NLR > 6.81 (HR:1.75; 95%CI [1.24–2.45]), moSII > 2027.12 (HR:2.46; 95%CI [1.49–4.04]), and PNI > 40.31 (HR:0.77; 95%CI [0.60,0.97]) for 5-year DFS. These outcomes were maintained in the whole cohort for NLR and moSII (p < 0.05) but not in stage II and for PNI in all tumoral stages. The associations of NLR-PNI and moSII-PNI were also a relevant prognostic factor for OS. Conclusions: High NLR, high moSII (for stages I and III), and low PNI (regardless of tumour stage) were the most promising preoperative biomarkers to predict poor OS and DFS in gastric cancer patients treated with curative intent.

Document Type

Article


Published version

Language

English

Publisher

MDPI

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Attribution 4.0 International

http://creativecommons.org/licenses/by/4.0/

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