Prognostic Relevance of Preoperative Immune, Inflammatory, and Nutritional Biomarkers in Patients Undergoing Gastrectomy for Resectable Gastric Adenocarcinoma: An Observational Multicentre Study
Por:
Tur-Martínez, J, Rodríguez-Santiago, J, Osorio, J, Miró, M, Yarnoz, C, Jofra, M, Ferret, G, Salvador-Roses, H, Fernández-Ananín, S, Clavell, A, Luna, A, Aldeano, A, Olona, C, Hermoso, J, Güell-Farré, M, Dal Cero, M, Gimeno, M, Pallarès, N, Pera, M
Publicada:
1 jun 2024
Resumen:
Simple Summary: The aim of this study was to evaluate 18 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 gastrectomy for gastric adenocarcinoma. This is 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 preoperative biomarkers for OS and DFS. The most relevant preoperative biomarkers of poorer OS and DFS were high neutrophil-to-lymphocyte ratio (NLR), high monocyte systemic inflammation index (moSII) (for stages I and III), and low prognostic nutritional index (PNI) (regardless tumour stage). 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.
Filiaciones:
Tur-Martínez, J:
Univ Autonoma Barcelona, Dept Surg, Barcelona 08035, Spain
Complex Hosp Univ Moises Broggi, Dept Surg, Sant Joan Despi 08970, Spain
Rodríguez-Santiago, J:
Univ Hosp Mutua Terrassa, Dept Surg, Terrassa 08221, Spain
Osorio, J:
Hosp Clin Barcelona, Dept Surg, Barcelona 08036, Spain
Miró, M:
Hosp Univ Bellvitge, Dept Surg, Lhospitalet De Llobregat 08907, Barcelona, Spain
Yarnoz, C:
Univ Publ Navarra, Hosp Univ Navarra, Dept Surg, Pamplona 31008, Spain
Jofra, M:
Hosp Univ Vall Hebron, Dept Surg, Barcelona 08035, Spain
Ferret, G:
Hosp Univ Josep Trueta, Dept Surg, Girona 17007, Spain
Salvador-Roses, H:
Hosp Arnau Vilanova, Dept Surg, Lleida 25198, Spain
Fernández-Ananín, S:
Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Dept Surg, Barcelona 08025, Spain
Clavell, A:
Univ Autonoma Barcelona, Hosp Univ Germans Trias & Pujol, Dept Surg, Badalona 08916, Spain
Luna, A:
Hosp Univ Parc Tauli Sabadell, Dept Surg, Sabadell 08208, Spain
Aldeano, A:
Hosp Gen Granollers, Dept Surg, Granollers 08402, Spain
Olona, C:
Hosp Univ Tarragona Joan XXIII, Dept Surg, Tarragona 43005, Spain
Hermoso, J:
Hosp Univ Vic, Dept Surg, Vic 08500, Spain
Güell-Farré, M:
Althaia Xarxa Assistencial Univ Manresa, Dept Surg, Manresa 08243, Spain
Univ Vic Univ Cent Cataluna UVIC UCC, Fac Med, Vic 08500, Spain
Inst Recerca & Innovacio Ciencies Vida & Salut Cat, Vic 08500, Spain
Dal Cero, M:
Univ Autonoma Barcelona, Hosp Mar, Hosp Mar Med Res Inst IMIM, Dept Surg,Sect Gastrointestinal Surg, Barcelona 08003, Spain
Gimeno, M:
Univ Autonoma Barcelona, Hosp Mar, Hosp Mar Med Res Inst IMIM, Dept Surg,Sect Gastrointestinal Surg, Barcelona 08003, Spain
Pallarès, N:
Germans Trias & Pujol Res Inst & Hosp IGTP, Biostat Support & Res Unit, Barcelona 08916, Spain
Pera, M:
Univ Autonoma Barcelona, Hosp Mar, Hosp Mar Med Res Inst IMIM, Dept Surg,Sect Gastrointestinal Surg, Barcelona 08003, Spain
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