Prognostic relevance of preoperative immune, inflammatory, and nutritional biomarkers in patients undergoing gastrectomy for resectable gastric adenocarcinoma: an observational multicentre study

Date

2024-06-11

Authors

Tur-Martínez, Jaume
Rodríguez-Santiago, Joaquín
Osorio, Javier
Miró, Mònica
Jofra, Mariona
Ferret, Georgina
Salvador-Roses, Helena
Fernández-Ananín, Sonia
Clavell, Arantxa

Director

Publisher

MDPI
Acceso abierto / Sarbide irekia
Artículo / Artikulua
Versión publicada / Argitaratu den bertsioa

Project identifier

Impacto

Abstract

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.

Description

Keywords

Gastric cancer, Preoperative biomarker, Preoperative immune score, Preoperative inflammation score, Preoperative nutritional score

Department

Ciencias de la Salud / Osasun Zientziak

Faculty/School

Degree

Doctorate program

item.page.cita

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. (2024) Prognostic relevance of preoperative immune, inflammatory, and nutritional biomarkers in patients undergoing gastrectomy for resectable gastric adenocarcinoma: an observational multicentre study. Cancers, 16(12), 1-17. https://doi.org/10.3390/cancers16122188.

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© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.

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