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

Autor: Tur-Martínez J; Department of Surgery, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain.; Department of Surgery, Complex Hospitalari Universitari Moisès Broggi, 08970 Sant Joan Despí, Spain., Rodríguez-Santiago J; Department of Surgery, University Hospital Mútua Terrassa, 08221 Terrassa, Spain., Osorio J; Department of Surgery, Hospital Clínic de Barcelona, 08036 Barcelona, Spain., Miró M; Department of Surgery, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, 08907 Barcelona, Spain., Yarnoz C; Department of Surgery, Hospital Universitario de Navarra, Universidad Pública de Navarra, 31008 Pamplona, Spain., Jofra M; Department of Surgery, Hospital Universitari Vall d'Hebron, 08035 Barcelona, Spain., Ferret G; Department of Surgery, Hospital Universitari Josep Trueta, 17007 Girona, Spain., Salvador-Roses H; Department of Surgery, Hospital Universitari Arnau de Vilanova, 25198 Lleida, Spain., Fernández-Ananín S; Department of Surgery, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, 08025 Barcelona, Spain., Clavell A; Department of Surgery, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, 08916 Badalona, Spain., Luna A; Department of Surgery, Hospital Universitari Parc Taulí de Sabadell, 08208 Sabadell, Spain., Aldeano A; Department of Surgery, Hospital General de Granollers, 08402 Granollers, Spain., Olona C; Department of Surgery, Hospital Universitari de Tarragona Joan XXIII, 43005 Tarragona, Spain., Hermoso J; Department of Surgery, Hospital Universitari de Vic, 08500 Vic, Spain., Güell-Farré M; Department of Surgery, Althaia Xarxa Assistencial Universitària de Manresa, 08243 Manresa, Spain.; Faculty of Medicine, Universitat de Vic-Universitat Central de Cataluña (UVIC-UCC), 08500 Vic, Spain.; Institut de Recerca i Innovació en Ciències de la Vida i de la Salut a la Catalunya Central (IRIS-CC), 08500 Vic, Spain., Dal Cero M; Section of Gastrointestinal Surgery, Hospital del Mar, Department of Surgery, Universitat Autònoma de Barcelona, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain., Gimeno M; Section of Gastrointestinal Surgery, Hospital del Mar, Department of Surgery, Universitat Autònoma de Barcelona, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain., Pallarès N; Biostatistics Support and Research Unit, Germans Trias i Pujol Research Institute and Hospital (IGTP), 08916 Barcelona, Spain., Pera M; Section of Gastrointestinal Surgery, Hospital del Mar, Department of Surgery, Universitat Autònoma de Barcelona, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain.
Jazyk: angličtina
Zdroj: Cancers [Cancers (Basel)] 2024 Jun 11; Vol. 16 (12). Date of Electronic Publication: 2024 Jun 11.
DOI: 10.3390/cancers16122188
Abstrakt: 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.
Databáze: MEDLINE
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