Prognostic Score System Using Preoperative Inflammatory, Nutritional and Tumor Markers to Predict Prognosis for Gastric Cancer: A Two-Center Cohort Study

Pang, Hua-Yang; Zhang, Weihan; Liang, Xiaofeng; Zhang, Ziqi; Chen, Xiao-Long; Zhao, Lin-Yong; Li, Kai; Galiullin, Danil; Yang, Kun; Hu, Jian‐Kun

doi:10.1007/s12325-021-01870-z

Cited by 22 publications

(22 citation statements)

References 42 publications

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“…Systematic review registration: https://www.crd.york.ac.uk/prospero/ display_record.php?RecordID=327370, identifier CRD42022327370. KEYWORDS gastri cancer, intensive follow-up, recurrence, survival outcomes, meta-analysis Background Gastric cancer (GC) is still one of the most common causes of cancer-related deaths worldwide, especially in East Asia (1,2). Once the GC is detected, surgery with curative intent is the treatment choice for nonmetastatic disease (3, 4).…”

Section: Discussionmentioning

confidence: 99%

“…For studies that HR with 95%CI was not reported, we then calculated them from the necessary data following the methods reported by Tierney et al. ( 21 ) Heterogeneity among studies was assessed using I ( 2 ) statistic. All pooled analyses were performed assuming the random-effects model, which accounts for variance across included studies.…”

Section: Methodsmentioning

confidence: 99%

“…Gastric cancer (GC) is still one of the most common causes of cancer-related deaths worldwide, especially in East Asia ( 1 , 2 ). Once the GC is detected, surgery with curative intent is the treatment choice for nonmetastatic disease ( 3 , 4 ).…”

Section: Introductionmentioning

confidence: 99%

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Detection of asymptomatic recurrence following curative surgery improves survival in patients with gastric cancer: A systematic review and meta-analysis

et al. 2022

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BackgroundTo date, there is no evidence that intensive follow-up provides survival benefit in gastric cancer patients undergoing curative gastrectomy. The aim of this study is to investigate the efficacy of detection of asymptomatic recurrence using intensive surveillance strategy in long-term survival after curative gastric cancer surgery.MethodsA systematic review of electronic databases including PubMed, Embase, Web of Science, the Cochrane Library and China National Knowledge Infrastructure, Clinical Trials Registry and Google Scholar was performed up to April 2022. The primary outcomes were survival outcomes: overall survival, recurrence-free survival and post-recurrence survival. The secondary endpoints were clinicopathological features, recurrence patterns and treatment after recurrence. The registration number of this protocol is PROSPERO CRD42022327370.ResultsA total of 11 studies including 1898 participants were included. In the pooled analysis, the detection of asymptomatic recurrence was significantly associated with an improved overall survival compared to patients showing symptoms of recurrence (HR=0.67; 95%CI: 0.57-0.79; P<0.001), which was primarily driven by the prolongation of post-recurrence survival (HR=0.51; 95%CI: 0.42-0.61; P<0.001), since there was no significant difference observed in recurrence-free survival (HR=1.12; 95%CI: 0.81-1.55; P=0.48) between the two groups. Meanwhile, male sex and advanced T stage were more frequently observed in the symptomatic recurrence group. Furthermore, patients in the symptomatic recurrence group had a higher proportion of peritoneal relapse but lower proportion of distant lymph node metastasis. Additionally, patients in the symptomatic recurrence group were less likely to receive surgery treatment and post-recurrence chemotherapy.ConclusionThe detection of asymptomatic recurrence using intensive follow-up was associated with an appreciable improvement in overall survival. However, more robust data from high-quality studies are still required to verify this issue.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=327370, identifier CRD42022327370.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Detection of asymptomatic recurrence following curative surgery improves survival in patients with gastric cancer: A systematic review and meta-analysis

et al. 2022

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“…Along with the fact that in ammation is strongly associated with all stages of development and that malignant progression of cancer has been veri ed in a vast majority of cancers, studies focusing on the effects of in ammatory markers on tumors have continued to emerge [17,18]. Numerous studies have shown that several in ammatory markers are related to the prognosis of gastrointestinal cancer, especially CRP, LMR PLR and NLR [19][20][21][22][23]. For advanced gastric cancer patients who have undergone preoperative neoadjuvant chemotherapy and radical resection, an associated study of Peking University Cancer Hospital reported that elevated NLR before NACT, preoperative anemia and larger change value of LMR implied an adverse prognosis [24].…”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of Inflammatory and Nutritional Markers in Perioperative Period for Patients with Advanced Gastric Cancer

Zhang

et al. 2022

Preprint

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Background: It has been reported that inflammatory and nutritional markers are related to prognosis in numerous malignancies. The present study analyzed the significance of these markers’ alterations during neoadjuvant chemotherapy in the long-term outcomes in patients with advanced gastric cancer. Methods: A retrospective review was performed of 437 advanced gastric cancer patients who underwent a neoadjuvant chemotherapy (NACT) regimen followed by surgical treatment. Blood samples for inflammatory and nutritional markers were collected from the patients before the first neoadjuvant chemotherapy and after the last neoadjuvant chemotherapy. Statistical analysis, including MannWhitney U or chisquare tests, the KaplanMeier method and Cox multivariate analysis, were performed to analyze the predictive value of these markers for overall survival outcomes (OS). Results: Most biomarkers, including lymphocyte, leucocyte, neutrophil, monocyte, platelet, LMR, PLR, SII, CRP, CAR, hemoglobulin and albumin levels, changed during NACT (P < 0.05). After separately grouping the patients according to the normal range of hematologic indexes and the change rate (α) of systemic inflammatory and nutritional markers by the cutoff value derived from X-tile (P < 0.05), we found that differentiation, TRG, pre-NACT BMI, pre-NACT platelet counts, post-NACT lymphocyte counts, the change in lymphocyte counts, change in platelet counts and LMR(α), PLR(α), SII(α), and CAR(α) were associated with OS. Multivariate analysis revealed that PLR (α) > -19% was correlated with a 3.193-fold (95% CI: 2.194–4.649) higher risk of death (P < 0.001) than others. Conclusion: NACT could significantly change several inflammatory and nutritional markers in the perioperative period; the platelet counts before NACT, and the change in lymphocytes during NACT truly correlated with long-term outcomes among patients with advanced gastric cancer. The systemic inflammatory marker PLR may be a reliable marker for the prediction of prognosis.

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“…Tumor-related hematological in ammatory biomarkers, such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR) and systemic immune-in ammation index (SII), have been reported as prognostic predictors for STS [14][15][16][17][18]. The systemic in ammatory-nutritional score (INS), a novel scoring system, is related to tumor occurrence, progression, and prognosis [18][19][20][21][22].…”

Section: Introductionmentioning

confidence: 99%

A novel systemic inflammatory-nutritional score (INS) and nomogram for the prognostic prediction of adult head and neck soft tissue sarcoma in patients undergoing R0 surgery

Qiu

et al. 2022

Preprint

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Background Head and neck soft tissue sarcoma (HNSTS) comprises a rare group of malignancies with high risks of recurrence and mortality. However, the biomarkers predicting the prognosis of HNSTS patients received R0 resection are limited. Here, we aimed to develop a novel inflammatory-nutritional score (INS) system and a nomogram to explore the prognostic value of preoperative biomarkers in HNSTS patients. Methods With a median follow-up time of 134.6 months, 315 patients with HNSTS who underwent R0 resection were enrolled. Clinical characteristics and hematological features were collected. The least absolute shrinkage and selection operator Cox regression model was used to select the most significant survival‑associated candidate for constructing the INS. The relationship between the INS groups and clinical features was analyzed. Further, a nomogram based on the INS and clinical features was generated by multivariate Cox analysis, assessed by the concordance index and internally validated by bootstraps. Results The five-year overall survival (OS) rate, three-year recurrence-free survival rate and disease-free survival (DFS) rate were 77.3%, 61.0% and 55.4%, respectively. After scoring, the novel INS system was established and divided into 3 groups: Low Risk (INS 0), Medium Risk (INS 1–3) and High Risk (INS 4–7). High INSs were associated with a deep tumor location (p < 0.001), high tumor grade (p < 0.001), and advanced American Joint Committee on Cancer stage (p < 0.001). The Low-Risk group exhibited a higher 5-year OS rate and 3-year DFS rate than the Medium-Risk and High-Risk groups (87.6% versus 81.3%% versus 53.3%, p < 0.001; 62.2% versus 56.9% versus 37.9%, p = 0.007). Moreover, the multivariate analysis demonstrated that the INS (p = 0.023), tumor depth (p < 0.001), pT stage (p = 0.022), pN stage (p < 0.001) and tumor grade (p < 0.001) were independent survival predictors for HNSTS patients. Based on these results, a novel prognostic nomogram for OS was generated, which showed a better performance than the p7TNMG stage alone (p < 0.001). Conclusions Our findings suggest that oncological outcomes among HNSTS patients who underwent R0 resection can be accurately predicted using the INS, therefore, an INS-based specific nomogram provides reliable, individualized prognostic information for patients with HNSTS to guide treatment strategies in clinical practice.

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Prognostic Score System Using Preoperative Inflammatory, Nutritional and Tumor Markers to Predict Prognosis for Gastric Cancer: A Two-Center Cohort Study

Cited by 22 publications

References 42 publications

Detection of asymptomatic recurrence following curative surgery improves survival in patients with gastric cancer: A systematic review and meta-analysis

Detection of asymptomatic recurrence following curative surgery improves survival in patients with gastric cancer: A systematic review and meta-analysis

Prognostic significance of Inflammatory and Nutritional Markers in Perioperative Period for Patients with Advanced Gastric Cancer

A novel systemic inflammatory-nutritional score (INS) and nomogram for the prognostic prediction of adult head and neck soft tissue sarcoma in patients undergoing R0 surgery

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