Prognostic Significance of Pre- and Postoperative Lymphocyte Counts in Patients with Gastric Cancer

Background: Although preoperative lymphopenia is reportedly a prognostic factor in cancer patients, the association between postoperative lymphopenia and patient prognosis has not been widely studied. Methods: We enrolled 352 patients who underwent surgery for gastric cancer (GC) between January 2005 and April 2013 to analyze correlations among pre- and postoperative lymphocyte counts (LCs) and prognosis in GC patients. Results: Pre- and postoperative (obtained 1 day after surgery) LCs were significantly correlated (r = 0.496, p < 0.0001). Pre- and postoperative LCs of elderly patients were significantly lower than those of non-elderly patients. Postoperative lymphocyte count was significantly lower in patients with a differentiated tumor than in those with an undifferentiated tumor. Based on the results of receiver operating characteristic analysis, patients were classified into subgroups as: preoperative LC ≥1,676 (pre-LCHigh), preoperative LC <1,676 (pre-LCLow); and as postoperative LC ≥855 (post-LCHigh), and postoperative LC <855 (post-LCLow). Five-year overall survival rates significantly differed between pre-LCHigh (82.5%) and pre-LCLow (71.6%) groups (p = 0.023); and also between the post-LCHigh (81.5%) and post-LCLow (69.5%) groups (p = 0.0072). The 5-year disease specific survival rates were 91.3 and 82.4% in patients with post-LCHigh and those with post-LCLow, respectively, and differences were statistically significant (p = 0.015). Multivariate analysis indicated that postoperative lymphocyte count was an independent prognostic indicator, along with age, gender, tumor size, lymph node metastasis, and venous invasion. Conclusions: Postoperative lymphocyte count is a useful predictive factor for prognosis in GC patients.

Download Full-text

Estimation of Physiological Ability and Surgical Stress Score Is a Useful Prognostic Indicator for Elderly Patients with Colorectal Cancer

Digestive Surgery ◽

10.1159/000497455 ◽

2019 ◽

Vol 37 (2) ◽

pp. 145-153 ◽

Cited By ~ 3

Author(s):

Manabu Yamamoto ◽

Hiroaki Saito ◽

Chihiro Uejima ◽

Akimitsu Tanio ◽

Yoichiro Tada ◽

...

Keyword(s):

Colorectal Cancer ◽

Elderly Patients ◽

Surgical Stress ◽

Survival Rates ◽

Prognostic Significance ◽

Prognostic Indicator ◽

Histopathological Diagnosis ◽

Characteristic Analysis ◽

Curative Surgery ◽

The Difference

Background: The incidence of colorectal cancer (CRC) among the elderly has been increasing. Therefore, determining postoperative prognosis factors in elderly CRC patients has clinical importance. This study retrospectively investigated the prognostic significance of the estimation of physiological ability and surgical stress (E-PASS) in elderly CRC patients. Methods: This study enrolled 166 elderly patients aged 75 or more with a histopathological diagnosis of colorectal adenocarcinoma who underwent curative surgery. Results: According to the results of receiver operating characteristic analysis, the patients were divided into the following 2 groups based on the comprehensive risk score (CRS): CRS of ≥0.05 (CRSHigh) and CRS of < 0.05 (CRSLow). The 5-year overall survival rates of CRSHigh group and CRSLow group were 51.1 and 89.6%, respectively, and the difference was statistically significant (p < 0.001). Furthermore, 5-year disease-specific survival rates of CRSHigh group and CRSLow group were 81.4 and 96.3%, respectively, and the difference was statistically significant (p = 0.017). Also, multivariate analysis indicated that CRS was an independent prognostic indicator in elderly CRC patients. With regard to the cause of death, both recurrence and cancer-unrelated deaths were observed significantly more in the CRSHigh group than in the CRSLow group. Conclusions: E-PASS was a useful prognostic indicator in elderly CRC patients.

Download Full-text

Combined Pre- and Postoperative Lymphocyte Count Accurately Predicts Outcomes of Patients with Colorectal Cancer

Digestive Surgery ◽

10.1159/000492340 ◽

2018 ◽

Vol 36 (6) ◽

pp. 487-494 ◽

Cited By ~ 4

Author(s):

Manabu Yamamoto ◽

Hiroaki Saito ◽

Chihiro Uejima ◽

Akimitsu Tanio ◽

Seigo Takaya ◽

...

Keyword(s):

Colorectal Cancer ◽

Multivariate Analysis ◽

Operating Characteristic ◽

Receiver Operating Characteristic Analysis ◽

Survival Rates ◽

Prognostic Indicator ◽

Disease Specific Survival ◽

Characteristic Analysis ◽

Patient Prognosis ◽

Disease Specific

Background: Although preoperative lymphopenia is reportedly a prognostic factor in cancer patients, the association between postoperative lymphopenia and patient prognosis has not been widely studied. Methods: We enrolled 379 patients who underwent surgery for colorectal cancer (CRC) to analyze correlations among pre- and postoperative lymphocyte counts (LCs) and prognosis in patients with CRC. Results: Pre- and postoperative LCs were significantly correlated (r = 0.615, p < 0.0001). Based on results of receiver operating characteristic analysis, patients were subgrouped as preoperative LC ≥1,280 (pre-LCHigh, n = 234), preoperative LC < 1,280 (pre-LCLow, n = 145); and as postoperative LC ≥680 (post-LCHigh, n = 246), and postoperative LC < 680 (post-LCLow, n = 133). Five-year disease-specific survival rates significantly differed between pre-LCHigh (88.6%) and pre-LCLow (72.5%) groups (p < 0.0001); and also between the post-LCHigh (88.5%) and post-LCLow (71.1%) groups (p < 0.0001). Five-year disease-specific survival rates of patients who were both pre-LCLow and post-LCLow was significantly lower than those for patients who were either pre-LCHigh or post-LCHigh or pre-LCHigh/post-LCHigh (p = 0.0003). Multivariate analysis indicated that the combination of pre- and postoperative LC was an independent prognostic indicator. Conclusions: The combination of pre- and postoperative LC is a predictive factor for prognosis in CRC patients.

Download Full-text

Evaluation of the Estimation of Physiologic Ability and Surgical Stress Score as a Prognostic Indicator for Older Patients with Gastric Cancer

Digestive Surgery ◽

10.1159/000497457 ◽

2019 ◽

Vol 37 (2) ◽

pp. 171-178 ◽

Cited By ~ 1

Author(s):

Yuki Murakami ◽

Hiroaki Saito ◽

Shota Shimizu ◽

Yusuke Kono ◽

Yuji Shishido ◽

...

Keyword(s):

Gastric Cancer ◽

Risk Score ◽

Surgical Stress ◽

Survival Rates ◽

Prognostic Significance ◽

Prognostic Indicator ◽

Histopathological Diagnosis ◽

Receiver Operating Characteristic Curves ◽

Auc Value ◽

Stress Score

Background: The incidence of gastric cancer (GC) among the older adults is increasing. Therefore, determining postoperative age-associated prognostic factors is clinically important. This present study retrospectively investigated the prognostic significance of the estimation of physiologic ability and surgical stress (E-PASS) of such patients with GC. Methods: We enrolled 136 patients aged ≥75 years with a histopathological diagnosis of gastric adenocarcinoma who underwent gastrectomy. Results: Receiver operating characteristic curves were generated to evaluate survival, and AUC values were compared to assess the discriminatory ability of carcinoembryonic antigen, the perioperative risk score, the surgical stress score, and the comprehensive risk score (CRS) of E-PASS. The AUC value of CRS was of the highest AUC value as a function of overall survival (OS) and disease-specific survival. The 5-year OS rates of CRSHigh and CRSLow groups were 50.6 and 76.9% (p = 0.0007) respectively. The 5-year DSS rates of the CRSHigh and CRSLow groups were 78.8 and 95.2% (p = 0.028) respectively. Further, the 5-year survival rates unrelated to cancer of the CRSHigh and CRSLow groups were 64.2 and 80.9% (p = 0.0096) respectively. Multivariate analysis identified that CRS was an independent prognostic indicator. Conclusions: E-PASS was a useful prognostic indicator for older GC patients.

Download Full-text

Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio: novel markers for the diagnosis and prognosis in patients with restenosis following CAS

Biomarkers in Medicine ◽

10.2217/bmm-2019-0155 ◽

2020 ◽

Vol 14 (4) ◽

pp. 271-282 ◽

Cited By ~ 1

Author(s):

Xiang Bao ◽

Gezhi Zhou ◽

Wei Xu ◽

Xiaobo Liu ◽

Zhijun Ye ◽

...

Keyword(s):

Operating Characteristic ◽

Receiver Operating Characteristic Analysis ◽

Prognostic Significance ◽

Area Under The Curve ◽

Prognostic Indicator ◽

Neutrophil To Lymphocyte Ratio ◽

Characteristic Analysis ◽

Platelet To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Diagnosis And Prognosis

Aim: In this study, we investigated the effect of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio on restenosis status in patients undergoing carotid angioplasty stenting (CAS). Methodology & results: Clinical imageology and receiver operating characteristic analysis were utilized to study the prognostic significance of NLRs/platelet-to-lymphocyte ratios and their correlation with survival. NLR of restenosis (+) patients was evidently increased after the CAS procedures, while the NLR of restenosis (-) patients before the CAS procedures being the lowest. Area under the curve of pre-CAS NLR or/and post-CAS NLR were all evidently higher than 50%. Also, restenosis incidence was the highest in patients with both high pre-CAS and high post-CAS values. Conclusion: Therefore, NLR can be utilized as an independent prognostic indicator to predict the incidence of restenosis after CAS procedures.

Download Full-text

Survival Based On The Pathologic Lymph Node Ratio For Local Advanced Gastric Cancer; Elderly Patients Versus Non Elderly Patients

10.21203/rs.3.rs-1176546/v1 ◽

2021 ◽

Author(s):

Omer Yalkin ◽

Nidal Iflazoglu ◽

Olgun Deniz ◽

Mustafa Yener Uzunoglu ◽

Ezgi Isil Turhan

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Elderly Patients ◽

Advanced Gastric Cancer ◽

Lymph Node Ratio ◽

Locally Advanced ◽

Survival Rates ◽

The Elderly ◽

Survival Difference ◽

Node Ratio

Abstract Objective: The aim of this study was to clarify the prognostic value of the pathological lymph node ratio for elderly and non-elderly gastric cancer patients and to evaluate whether there is a difference in the survival of patients with the same LNR (Lymph Node Ratio).Materials and Methods: A total of 222 patients diagnosed with locally advanced gastric cancer and who underwent gastrectomy were included. The patients were divided into two groups according to age. Clinicopathological properties of the two groups were compared. Potential prognostic factors affecting survival were analyzed. Subsequently, the effect of lymphadenectomy and LNR on survival in both groups was evaluated. Results: Significant differences were detected in terms of the location of primary lesions, hemoglobin and albumin levels between elderly patients and non-elderly patients (p < .05). Overall survival (OS) was significantly worse in elderly patients (22 months vs. 67 months, p<0.001). The survival rates in elderly patients were significantly lower from those of non-elderly in the subgroup LNR Stage 2 (12.1% vs. 47.9 %, P = 0.004) and LNR Stage 3 classification (9.1% vs. 34.1%, P = 0.039). LNR was found to be significant for OS with a cut-off point of 0.18. Conclusion: A survival difference was found between the elderly and non-elderly patients with the same LNR. LNR was found to be an independent factor for survival especially in elderly patients. Survival was found to be further decreased in elderly patients compared to non-elderly patients with increasing LNR.

Download Full-text

Prognostic significance of ADAM17 expression in patients with gastric cancer who underwent curative gastrectomy.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.3_suppl.60 ◽

2015 ◽

Vol 33 (3_suppl) ◽

pp. 60-60

Author(s):

Ahmet Bilici ◽

Dincer Aydin ◽

Dilek Yavuzer ◽

Hatice Odabas ◽

Ozlem Ercelep ◽

...

Keyword(s):

Gastric Cancer ◽

Multivariate Analysis ◽

Molecular Marker ◽

Cancer Progression ◽

Prognostic Significance ◽

Disease Free Survival ◽

Prognostic Indicator ◽

Curative Gastrectomy ◽

Prognostic Importance ◽

Gastric Cancer Patients

60 Background: Tumor invasion and metastasis are complex processes, involving regulation at the molecular level of adhesive molecules, proteolitic enzymes, and cell growth and angiogenesis factors. A Disintegrin and Metalloproteinase (ADAM)17 has been indicated to be indispensable regulator of celular event from proliferation to migration.Although prognostic importance of ADAM17 expression has been investigated in several tumors, its clinical utility as a useful prognostic molecular marker remains unclearin gastric cancer.In the present study, we evaluated the expression of ADAM17 and its prognostic significance in gastric cancer patients after surgery. Methods: Prognostic significance of ADAM17 expression was analyzed by immunohistochemically in 158 patients with gastric cancer and the relationship between its expression and clinicopathological factors was also evaluated. Results: High expression of ADAM17 was detected in 81 patients(51%),while low expression was found in 77 cases (49%). There was significant correlation between gender, histology, lymph node metastasis, vascular invasion, the presence of recurrence and high ADAM17 expression. Recurrence in patients with high ADAM17 expression was significantly higher than that for patients with low ADAM17 expression(p=0.032). The median disease-free survival (DFS) time for patients with high ADAM17 expressed tumors were worse than those of patients with low ADAM17 expressed tumor (16.6 vs. 44.2 months, p=0.004).In addition, patients with low ADAM17 expression had a higher median overall survival (OS)interval than those of high ADAM17 expressed patients (49.6 vs. 26.9 months, p=0.019). Multivariate analysis indicated that the rate of ADAM17 expression was an independent prognostic factor for DFS, in addition to known important clinicopathological prognostic indicator for DFS. But its' prognostic importance could not be proved by multivariate analysis for OS. Conclusions: The potential value of ADAM17 expression as a useful molecular marker in gastric cancer progression should be evaluated comprehensively,it may predict recurrence and poor prognosis in patients with gastric cancer after curative resection.

Download Full-text

CD44 and CD44v6 are Correlated with Gastric Cancer Progression and Poor Patient Prognosis: Evidence from 42 Studies

Cellular Physiology and Biochemistry ◽

10.1159/000452570 ◽

2016 ◽

Vol 40 (3-4) ◽

pp. 567-578 ◽

Cited By ~ 11

Author(s):

Min Fang ◽

Junrong Wu ◽

Xin Lai ◽

Huaying Ai ◽

Yifeng Tao ◽

...

Keyword(s):

Gastric Cancer ◽

Cancer Progression ◽

Histological Grade ◽

Prognostic Significance ◽

Lymphatic Invasion ◽

Poor Patient ◽

Patient Prognosis ◽

Gastric Cancer Progression ◽

Prognostic Power ◽

Cd44v6 Expression

Background/Aims: The prognostic power of the levels of total CD44 and its isoform CD44v6 for patients with gastric cancer (GC) remains controversial. Therefore, our study aims to generalize the clinicopathological and prognostic significance of these two proteins in GC. Methods: A literature search of the PubMed, Web of Science and Embase databases was conducted to identify eligible studies. The odds ratio (OR) with a 95% confidence interval (CI) was used to assess the effects. Results: In all, 42 studies including 6,229 patients were included in this analysis. Total CD44 was mentioned in 21 papers, and the results showed that CD44 was positively correlated with the T category, the N category, distant metastasis, lymphatic invasion and TNM stage. Moreover, patients with CD44 overexpression had a lower 5-year overall survival (OS) rate (OR = 3.35, 95%CI = 1.83-6.13). CD44v6 was mentioned in 24 studies, with results that were similar to those for total CD44. However, total CD44 or CD44v6 expression was not correlated with tumor size and histological grade. Conclusion: High CD44 or CD44v6 expression levels were correlated with cancer progression and poor prognosis in patients with GC. Both CD44 and CD44v6 may be useful diagnostic or prognostic biomarkers for GC.

Download Full-text

Clinical significance of conversion surgery for gastric cancer with peritoneal dissemination: A retrospective study

10.21203/rs.3.rs-19825/v1 ◽

2020 ◽

Author(s):

Takaaki Arigami ◽

Daisuke Matsushita ◽

Keishi Okubo ◽

Takashi Kijima ◽

Masataka Shimonosono ◽

...

Keyword(s):

Gastric Cancer ◽

Retrospective Study ◽

Progressive Disease ◽

Tumor Response ◽

Peritoneal Dissemination ◽

Survival Rates ◽

Prognostic Significance ◽

Distant Metastases ◽

Conversion Surgery ◽

Response To Chemotherapy

Abstract Background: Although chemotherapy has been clinically recommended as the initial treatment for patients with peritoneal dissemination of gastric cancer, poor prognosis has been noted among the same patients. However, the prognostic significance of conversion surgery after chemotherapy remains unclear. The present study therefore aimed to assess the clinical impact of conversion surgery among patients with peritoneal dissemination of gastric cancer.Methods: A total of 93 patients with peritoneal dissemination of gastric cancer undergoing chemotherapy between February 2002 and October 2019 were retrospectively enrolled and subsequently divided into progressive disease (PD) and non-PD groups based on tumor response to chemotherapy.Results: Among the included patients, 17 developed distant metastases at another site besides peritoneal dissemination. Based on tumor response, 24 and 69 patients were determined to have PD and non-PD, respectively, with the former having significantly poorer prognosis than the latter (p < 0.0001). A total of 19 patients underwent conversion surgery after chemotherapy, with the presence or absence of conversion surgery being significantly correlated with age, first-line chemotherapy regimen, and tumor response (p = 0.0134, 0.0337, and 0.0024, respectively). Patients in the non-PD group who underwent conversion surgery or chemotherapy alone had 3-year overall survival rates of 55.6% and 6.6%, respectively. Multivariate analysis identified conversion surgery alone as an independent prognostic factor in the non-PD group (p < 0.0001).Conclusion: Our retrospective study demonstrated that conversion surgery for gastric cancer with peritoneal dissemination might improve the prognosis of responders who developed no peritoneal dissemination after chemotherapy.

Download Full-text

Prealbumin and lymphocyte-based prognostic score, a new tool for predicting long-term survival after curative resection of stage II/III gastric cancer

British Journal Of Nutrition ◽

10.1017/s0007114518002854 ◽

2018 ◽

Vol 120 (12) ◽

pp. 1359-1369 ◽

Cited By ~ 12

Author(s):

Qian Shen ◽

Wu Liu ◽

Hu Quan ◽

Shuguang Pan ◽

Shuang Li ◽

...

Keyword(s):

Gastric Cancer ◽

Retrospective Study ◽

Lymphocyte Count ◽

Prognostic Score ◽

Locally Advanced ◽

Prognostic Significance ◽

Disease Free Survival ◽

Stage Ii ◽

Predictive Score ◽

Term Survival

AbstractThe aim of this retrospective study was to investigate the prognostic significance of pre-treatment immunological and nutritional statuses in patients with locally advanced gastric cancer (GC), and to use the risk factors to develop a predictive score. A total of 731 patients who underwent gastrectomy for stage II/III GC from November 2010 to December 2015 were recruited into this retrospective study. On the basis of univariate and further multivariate Cox regression analyses, decreased pretreatment lymphocyte count (<1·5×109/litre) and prealbumin concentrations (<180 mg/l) were identified to be independently associated with poorer overall survival (OS) and disease-free survival (DFS). Low albumin concentrations (<33 g/l) were identified as an independent risk factor only for OS, but not for DFS. Thereafter, patients who had a decreased prealbumin concentration and lymphocyte count were given a combination of serum prealbumin concentration and lymphocyte count (Co-PaL) score of 2. Patients with only one or neither of these concentrations were given a Co-PaL score of 1 or 0, respectively. Both the OS and the DFS time were inversely related to the Co-PaL scores, and the differences among the three groups were all significant. In contrast, the prognosis did not differ significantly between patients with good nutrition and those with mild to moderate malnutrition according to the prognostic nutritional index. This study indicated that the simple scoring system could accurately predict the prognosis of patients who underwent gastrectomy for stage II/III GC. The score might be helpful in terms of clinical preoperative decision-making.

Download Full-text

Development and Validation of a Prognostic Nomogram to Predict Overall Survival of Elderly Patients with Gastric Cancer

10.21203/rs.3.rs-36638/v1 ◽

2020 ◽

Author(s):

Xingguo Zhou ◽

Yinlu Ding ◽

Yu Wang ◽

Ying Xue ◽

Yifeng Zang ◽

...

Keyword(s):

Gastric Cancer ◽

Overall Survival ◽

Elderly Patients ◽

Receiver Operating Characteristic ◽

Clinical Utility ◽

Operating Characteristic ◽

Term Survival ◽

Ajcc Stage ◽

Development And Validation ◽

Receiver Operating

Abstract Background Gastric cancer (GC) is one of the most common malignant tumors of digestive tract origin in China. The proportion of elderly patients with gastric cancer (GC) gradually increases as the population ages. We aimed to develop a prognostic nomogram for prediction of elderly (≥ 75 years old) GC patients in overall survival (OS). Patients and Methods Patients with GC from 2005 to 2014 were selected from the Surveillance, Epidemiology, and End Result (SEER) database and randomly assigned to development and validation sets. The variables for establishing nomogram were confirmed by univariate and multivariate Cox proportional hazard analysis based on the development set. The predictive accuracy and discriminative ability of the model was evaluated using the receiver operating characteristic (ROC) curve, the concordance index (C-index) and calibration curves, while its clinical utility was assessed using decision curve analysis (DCA) and Kaplan-Meier curve. Results A total of 1445 patients were included in this study. The nomogram was developed including histologic grade, AJCC stage T, N, M and surgery according to the univariate and multivariate cox regression analysis, the area under the time-dependent receiver operating characteristic curve (AUC) and Occam’s Law of Razor. The C-index of the nomogram was higher than the TNM system in the training cohort (0.710 vs 0.652, p < 0.001), which was also confirmed in the validation cohort (0.701 vs 0.643, p < 0.001); and high AUCs were noted in both development and validation sets. The nomogram showed good discrimination and calibration in both development and validation sets. The DCA curves showed that the nomogram had better clinical utility compared to the AJCC stage model. In addition, participants could be divided into three disparate risk groups (low, moderate, high) by the nomogram. Conclusion This study established a prognostic nomogram that improved the performance of the AJCC staging system with incorporation of risk factors to better predict the short-term survival in elderly GC patients.

Download Full-text