Significance of Systemic Inflammatory Markers as Prognostic Predictors in Stage II/III Gastric Cancer Among Older Patients.

IF 1.6 4区医学 Q4 ONCOLOGY

Anticancer research Pub Date : 2025-04-01 DOI:10.21873/anticanres.17549

Kenji Kuroda, Takahiro Toyokawa, Gen Tsujio, Yuichiro Miki, Mami Yoshii, Hiroaki Kasashima, Tatsunari Fukuoka, Tatsuro Tamura, Masatsune Shibutani, Shigeru Lee, Masakazu Yashiro, Kiyoshi Maeda

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引用次数: 0

Abstract

Background/aim: Determining treatment for older patients is difficult because of their life expectancy and reduced physiological function. Recently, systemic inflammatory markers have been recognized as prognostic predictors in various cancers. However, few studies have focused on older patients with advanced gastric cancer. This study compared the prognostic significance of various markers in stage II and III gastric cancer in patients ≥75 years old.

Patients and methods: In total, 133 cases of R0 excision for stage II/III gastric cancer in patents ≥75 years old were analyzed. The ratio of neutrophils to lymphocytes (NLR), the ratio of platelets to lymphocytes (PLR), C-reactive protein to albumin (CAR), the prognostic nutritional index (PNI), and the Glasgow Prognostic Score (GPS) were used as preoperative markers. Cutoff value was determined based on the time-dependent ROC curve with the 5-year survival rate as the endpoint. Patients were divided into two groups based on these cutoff values, and their prognoses were compared.

Results: The cutoff values for NLR, PLR, CAR, and PNI were 2.83, 272, 0.06, and 44.8, respectively. In multivariate analysis for overall survival (OS), NLR (HR=1.972, 95%CI=1.231-3.158, p=0.005), CAR (HR=1.855, 95%CI=1.166-2.952, p=0.009), and PNI (HR=0.585, 95%CI=0.356-0.960, p=0.034) were independent prognostic factors. The NLR-CAR score, calculated based on the NLR and CAR cutoff values, was also an independent prognostic factor for OS (HR=1.883, 95%CI=1.162-3.051, p=0.010). In patients treated with adjuvant chemotherapy, the group with a high NLR-CAR score had significantly worse OS than the group with a low NLR-CAR score (p=0.001).

Conclusion: The combination of NLR and CAR may be useful for predicting the prognosis of older patients with advanced gastric cancer.

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系统性炎症标志物作为老年II/III期胃癌患者预后预测指标的意义

背景/目的：确定老年患者的治疗方法是困难的，因为他们的预期寿命和生理功能下降。最近，全身性炎症标志物已被认为是各种癌症的预后预测因子。然而，很少有研究关注老年晚期胃癌患者。本研究比较了年龄≥75岁的胃癌II期和III期患者各种标志物的预后意义。患者和方法：对年龄≥75岁的II/III期胃癌患者R0切除术133例进行分析。中性粒细胞与淋巴细胞之比（NLR）、血小板与淋巴细胞之比（PLR）、c反应蛋白与白蛋白（CAR）、预后营养指数（PNI）和格拉斯哥预后评分（GPS）作为术前指标。以5年生存率为终点，根据随时间变化的ROC曲线确定截断值。根据这些临界值将患者分为两组，并对其预后进行比较。结果：NLR、PLR、CAR、PNI的临界值分别为2.83、272、0.06、44.8。在总生存率（OS）的多因素分析中，NLR （HR=1.972, 95%CI=1.231 ~ 3.158, p=0.005）、CAR （HR=1.855, 95%CI=1.166 ~ 2.952, p=0.009）、PNI （HR=0.585, 95%CI=0.356 ~ 0.960, p=0.034）为独立预后因素。基于NLR和CAR截断值计算的NLR-CAR评分也是OS的独立预后因素（HR=1.883, 95%CI=1.162-3.051, p=0.010）。在接受辅助化疗的患者中，高NLR-CAR评分组的OS明显差于低NLR-CAR评分组（p=0.001）。结论：NLR联合CAR可用于预测老年晚期胃癌患者的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Anticancer research 医学-肿瘤学

CiteScore

3.70

自引率

10.00%

发文量

566

审稿时长

2 months

期刊介绍： ANTICANCER RESEARCH is an independent international peer-reviewed journal devoted to the rapid publication of high quality original articles and reviews on all aspects of experimental and clinical oncology. Prompt evaluation of all submitted articles in confidence and rapid publication within 1-2 months of acceptance are guaranteed. ANTICANCER RESEARCH was established in 1981 and is published monthly (bimonthly until the end of 2008). Each annual volume contains twelve issues and index. Each issue may be divided into three parts (A: Reviews, B: Experimental studies, and C: Clinical and Epidemiological studies). Special issues, presenting the proceedings of meetings or groups of papers on topics of significant progress, will also be included in each volume. There is no limitation to the number of pages per issue.