An immune checkpoint score system for prognostic evaluation and adjuvant chemotherapy selection in gastric cancer

AbstractImmunosuppressive molecules are extremely valuable prognostic biomarkers across different cancer types. However, the diversity of different immunosuppressive molecules makes it very difficult to accurately predict clinical outcomes based only on a single immunosuppressive molecule. Here, we establish a comprehensive immune scoring system (ISSGC) based on 6 immunosuppressive ligands (NECTIN2, CEACAM1, HMGB1, SIGLEC6, CD44, and CD155) using the LASSO method to improve prognostic accuracy and provide an additional selection strategy for adjuvant chemotherapy of gastric cancer (GC). The results show that ISSGC is an independent prognostic factor and a supplement of TNM stage for GC patients, and it can improve their prognosis prediction accuracy; in addition, it can distinguish GC patients with better prognosis from those with high prognostic nutritional index score; furthermore, ISSGC can also be used as a tool to select GC patients who would benefit from adjuvant chemotherapy independent of their TNM stages, MSI status and EBV status.

Download Full-text

Postoperative adjuvant chemotherapy with S-1 versus SOX/XELOX regimens for pStage III gastric cancer: A cohort study.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.4_suppl.358 ◽

2020 ◽

Vol 38 (4_suppl) ◽

pp. 358-358

Author(s):

Nobuhiro Tsuchiya ◽

Chikara Kunisaki

Keyword(s):

Gastric Cancer ◽

Adjuvant Chemotherapy ◽

Adverse Effects ◽

Therapy Group ◽

Sensory Neuropathy ◽

Prognostic Nutritional Index ◽

Postoperative Adjuvant Chemotherapy ◽

Curative Gastrectomy ◽

Nutritional Index ◽

Peripheral Sensory

358 Background: Adjuvant chemotherapy following curative gastrectomy is recommended for patients with pStage II or III, except pT3 (ss), N0 gastric cancer in Japan. This study aimed to compare the efficacy of postoperative adjuvant chemotherapy with S-1 versus SOX/XELOX for pStageIII gastric cancer. Methods: Between January 2015 and December 2018, 51 patients with pStage III gastric cancer underwent curative gastrectomy. The combination therapy group received a combined SOX and XELOX regimen as follows: (1) SOX regimen: 130 mg/m2 of oxaliplatin on day 1 every 3 weeks combined with 40 mg/m2 of S-1 twice daily on days 1–14 every 3 weeks; (2) XELOX regimen: 130 mg/m2 of oxaliplatin on day 1 every 3 weeks combined with 1000 mg/m2 of capecitabine twice daily on days 1–14 every 3 weeks. We evaluated their hospital records retrospectively. The indication of SOX/XELOX regimens was based on PS and intent of patients. Results: The S-1 group comprised 28 cases (pStage III A/B/C: 12/8/8), while the SOX/XELOX group comprised 23 cases (pStage III A/B/C: 4/10/9). There was no difference in age, sex, comorbidity, prognostic nutritional index and stage between two groups. The 2-year DFS of the S-1 group and the SOX/XELOX group were 58.6% and 71.7%, respectively (p = 0.367). Subgroup analysis showed that the 2-year DFS of patients with pStage IIIC gastric cancer in the S-1 group was significantly lower than the SOX/XELOX group (S-1 vs. SOX/XELOX: 25.9% vs. 78.7%, p = 0.041). As concerns adverse effects (CTCAE ver 4.0), peripheral sensory neuropathy was significantly higher in the SOX/XELOX group than in the S-1 group (S-1: grade I/II 3.6%/0% vs. SOX/XELOX: grade I/II 21.7%/34.8%, p < 0.001), although the other adverse effects did not differ between the two groups. Conclusions: SOX/XELOX therapy may be more useful than S-1 therapy for more advanced tumors among pStage III gastric cancers.

Download Full-text

Association among the prognostic nutritional index, completion of adjuvant chemotherapy, and cancer-specific survival after curative resection of stage II/III gastric cancer

European Journal of Clinical Nutrition ◽

10.1038/s41430-019-0502-1 ◽

2019 ◽

Vol 74 (4) ◽

pp. 555-564 ◽

Cited By ~ 3

Author(s):

Hua Xiao ◽

Huijun Zhou ◽

Peng Zhang ◽

Haifan Xiao ◽

Ke Liu ◽

...

Keyword(s):

Gastric Cancer ◽

Adjuvant Chemotherapy ◽

Curative Resection ◽

Prognostic Nutritional Index ◽

Stage Ii ◽

Cancer Specific Survival ◽

Nutritional Index

Download Full-text

Value of Prognostic Nutritional Index as a Predictor of Lymph Node Metastasis in Gastric Cancer

Anticancer Research ◽

10.21873/anticanres.13901 ◽

2019 ◽

Vol 39 (12) ◽

pp. 6843-6849 ◽

Cited By ~ 1

Author(s):

TOSHIYUKI KOSUGA ◽

TOMOKI KONISHI ◽

TAKESHI KUBOTA ◽

KATSUTOSHI SHODA ◽

HIROTAKA KONISHI ◽

...

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Prognostic Nutritional Index ◽

Node Metastasis ◽

Nutritional Index

Download Full-text

The Preoperative Prognostic Nutritional Index Predicts Short-Term and Long-Term Outcomes of Patients with Stage II/III Gastric Cancer: Analysis of a Multi-Institution Dataset

Digestive Surgery ◽

10.1159/000497454 ◽

2019 ◽

Vol 37 (2) ◽

pp. 135-144 ◽

Cited By ~ 8

Author(s):

Masahiro Sasahara ◽

Mitsuro Kanda ◽

Seiji Ito ◽

Yoshinari Mochizuki ◽

Hitoshi Teramoto ◽

...

Keyword(s):

Gastric Cancer ◽

Area Under The Curve ◽

Prognostic Nutritional Index ◽

Stage Ii ◽

Long Term Outcomes ◽

Short Term ◽

Nutritional Index ◽

Appropriate Treatment ◽

Disease Free

Background/Aims: Identification of nutritional indicators to predict short-term and long-term outcomes is necessary to provide appropriate treatment to patients with gastric cancer. Methods: We designed an analysis of a multicenter dataset of patients with gastric cancer who underwent gastrectomy between 2010 and 2014. We enrolled 842 eligible patients who had stage II/III gastric cancer. The area under the curve (AUC) values were compared among prognostic nutritional index (PNI), calculated as 10 × albumin g/dL + 0.005 × total lymphocyte count/mm3, and its constituents, and the predictive value of preoperative PNI for postoperative short-term and long-term outcomes was evaluated. Results: Preoperative PNI exhibited higher AUC values (0.719) for 1-year survival than its constituents, and the optimal cutoff value was 47. The disease-free and overall survival of patients in the PNI-low group were significantly shorter compared with those in the PNI-high group. The prognostic difference between the PNI-high and PNI-low groups was significantly greater in the subgroup of patients who underwent total gastrectomy. Clinically relevant postoperative complications were more frequently observed in the PNI-low group. Conclusions: The preoperative PNI is a useful predictor reflecting the incidence of complications after gastrectomy and the prognosis of patients with stage II/III gastric cancer.

Download Full-text

The usefulness of Roux-en-Y reconstruction with aboral pouch following total gastrectomy for gastric cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.4_suppl.209 ◽

2017 ◽

Vol 35 (4_suppl) ◽

pp. 209-209

Author(s):

Shirou Iwagami ◽

Sugihara Hidetaka ◽

Takao Mizumoto ◽

Tatsuo Kubota ◽

Nobutomo Miyanari ◽

...

Keyword(s):

Gastric Cancer ◽

Total Gastrectomy ◽

Prognostic Nutritional Index ◽

Short Term ◽

Common Procedure ◽

Term Outcome ◽

Nutritional Parameters ◽

Nutritional Index ◽

One Year ◽

Outcome Of Surgery

209 Background: Patients with gastric cancer that involves the upper part of the stomach should undergo total gastrectomy for their curative resection. Roux-en-Y reconstruction is the most common procedure followingtotal gastrectomy. However, this reconstruction causes them various postgastrectomy symptoms and problems of their nutritional status and QOL. Although the development of the new reconstruction to prevent these symptoms have being carried out, we have not generally established procedures. Methods: To compare the feasibility and the nutritional parameters of the patients with Roux-en-Y reconstruction with aboral pouch following total gastrectomy to the simple Roux-en-Y. From February 2011 to June 2014, sixty three patients with gastric cancer underwent total gastrectomy. We analyzed the short-term outcome of surgery and the nutritional parameters in two groups. Results: The aboral pouch was created as a side to side anastomosis approximately 50 cms distal to the esophagojejunostomy, 12 cm in length. Most nutritional parameters after surgery were similar in two groups. However, lymphocyte, serum albumin and prognostic nutritional index in aboral pouch group one year later were good tendency compared with simple Roux-en-Y group. Conclusions: Roux-en-Y reconstruction with aboral pouch might become one of the standard methods after total gastrectomy for gastric cancer.

Download Full-text