Role of systemic immune-inflammatory index, tumor infiltrating neutrophils and PD-1+ T cells to predict the postoperative recurrence after S-1 adjuvant chemotherapy for gastric cancer: A retrospective study.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 74-74
Author(s):  
Hiroaki Tanaka ◽  
Tatsuro Tamura ◽  
Soichiro Hiramatsu ◽  
Kazuya Muguruma ◽  
Yuichiro Miki ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
T Cells ◽  
Adjuvant Chemotherapy ◽  
Prognostic Score ◽  
Univariate Analysis ◽  
Glasgow Prognostic Score ◽  
Predictive Marker ◽  
Stage Ii ◽  
University Hospital ◽  
Neutrophil Lymphocyte Ratio

74 Background: The adjuvant chemotherapy with S-1 is the standard treatment for Stage II/III gastric cancer in Japan. Immunological status of host is critical for treatment outcome. Several investigators showed that systemic immune-inflammaotry indexes including neutrophil lymphocyte ratio (NLR) and modified Glasgow Prognostic Score (mGPS) well reflected the tumor progression. Methods: We analyzed clinical data obtained from 170 patients with pathological stage II/III gastric cancer who underwent surgery followed by S-1 adjuvant chemotherapy at Osaka City University Hospital between 2006 and 2015. Tumor infiltrating cells were detected by immunohistochemistry. Results: We found recurrent diseases in 70 (41%) patients including 15 in stage II and 55 in stage III. In univariate analysis using Cox proportion model, 2 grade of mGPS, the increase value of post-operative CEA, CA19-9, number of lymphocytes and NLR were associated with recurrence. Post-operative elevation of CEA and NLR were identified as independent risk factors for recurrence in multivariate analysis. Increase value of pre-operative NLR and CEA was significantly associated with early recurrent within one year after surgery. Tumor infiltrating neutrophils and PD-1+ T cells had correlated with the increase of pre-operative NLR and CEA value, respectively. Patients with low PD-1+T cells and low neutrophils had better prognosis than those with high infiltration. Conclusions: Post-surgical elevation of CEA and NLR value were useful as a predictive marker for recurrence in patients treated with S-1 adjuvant chemotherapy after surgery for gastric cancer. Early recurrence had correlated with tumor infiltrating neutrophils and PD-1+T cells. Our results suggested that systemic and local immune suppression should be an important element to exacerbate prognosis after chemotherapy for resectable gastric cancer.

scholarly journals A New Risk Model Predicting Overall Survival Using Preoperative Nutritional and Inflammation Status (NIS) in Patients After Curative Resection of Colorectal Cancer

2021 ◽  
Author(s):  
Tamuro Hayama ◽  
Tsuyoshi Ozawa ◽  
Mitsuo Tsukamoto ◽  
Yoshihisa Fukushima ◽  
Ryu Shimada ◽  
...  
Keyword(s):  
Overall Survival ◽  
Cancer Progression ◽  
Curative Resection ◽  
Risk Model ◽  
Prognostic Score ◽  
Glasgow Prognostic Score ◽  
University Hospital ◽  
Rank Test ◽  
Preoperative Body Mass Index ◽  
Neutrophil Lymphocyte Ratio

Abstract It has been shown that nutritional status correlates with survival in patients with various kinds of cancers. Besides, cancer causes inflammation which has been suggested to stimulate cancer progression. Therefore, inflammation status also has shown to reflect prognosis of cancers. In this study, we evaluated several kinds of nutritional and inflammation parameters in preoperative blood samples and constructed new risk model predicting a survival in patients with CRC (colorectal cancers). We retrospectively examined 286 patients with stage I-III CRC who had undergone curative resection in Teikyo University Hospital between 2013 to 2017. The association between overall survival (OS) and preoperative body mass index, albumin (Alb), cholesterol (Chol), and lymphocyte count, white blood cell count (WBC), neutrophil count (Neu), platelet count (Plt), C-reactive protein (CRP) were examined using Kaplan-Meier curve and log rank test. and eventually Alb, Chol, Neu, Plt, and CRP were shown to correlate with OS. Alb, Chol, Neu, Plt, and CRP were shown to correlate with OS. We constructed a new risk model (NIS: nutrition inflammation status) using these factors, and compared its usefulness with known models such as CRP-albumin ratio (CAR), Glasgow prognostic score (GPS), prognostic nutritional index (PNI), and neutrophil lymphocyte ratio (NLR). NIS prepared using nutritional indicators and inflammatory findings was useful as a new model for predicting overall survival in patients undergoing curative resection for CRC, compared with known models.

scholarly journals Clinical significance of peripheral blood-derived inflammation markers in advanced gastric cancer after radical resection

2020 ◽  
Author(s):  
Lihu Gu ◽  
Bangsheng Chen ◽  
Dingcheng Zheng ◽  
Jiahang Mo ◽  
Lingling Yuan ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Adjuvant Chemotherapy ◽  
Peripheral Blood ◽  
Inflammatory Markers ◽  
Prognostic Score ◽  
Glasgow Prognostic Score ◽  
Inflammation Markers ◽  
Optimal Cutoff

Abstract Background and objective: The prognostic significance of peripheral blood-derived inflammation markers in patients with gastric cancer (GC) has not been elucidated. This study aimed to investigate the relationship between systemic inflammatory markers and GC prognosis.Methods: A prospective observational cohort study involving 598 patients was conducted to analyze the prognosis of GC based on systemic inflammatory markers. The following peripheral blood-derived inflammation markers were evaluated: the neutrophil-lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), systemic immune-inflammation index (SII), C-reactive protein/albumin (CRP/Alb) ratio, Glasgow Prognostic Score (GPS), modified Glasgow Prognostic Score (mGPS), prognostic nutrition index (PNI), and prognostic index (PI). The receiver operating characteristics (ROC) curve and the Youden index were used to determine the optimal cutoff values. Univariate and multivariate analysis of prognostic factors was conducted accordingly.Results: The optimal cutoff values of the PNI, fibrinogen, NLR, PLR, SII, and CRP/Alb were 49.5, 397ng/dl, 2.5, 154, 556, and 0.05, respectively. Multivariate analysis showed that age, PLR, TNM stage, and chemotherapy were the independent prognostic factors for advanced gastric cancer (AGC). Adjuvant chemotherapy improved the long-term prognosis of patients with PLR ≥154, but chemotherapy had no significant effect on the survival of patients with PLR <154.Conclusions: Our findings show that higher PLR (≥154) is an independent risk factor for poor prognosis in GC patients. Besides, PLR can predict adjuvant chemotherapy (oxaliplatin/5-fluorouracil combination) response in patients with GC after surgery.

scholarly journals Clinical significance of peripheral blood-derived inflammation markers in advanced gastric cancer after radical resection

2020 ◽  
Author(s):  
Lihu Gu ◽  
Mian Wang ◽  
Xuena Cui ◽  
Jiahang Mo ◽  
Lingling Yuan ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Adjuvant Chemotherapy ◽  
Peripheral Blood ◽  
Inflammatory Markers ◽  
Prognostic Score ◽  
Glasgow Prognostic Score ◽  
Inflammation Markers ◽  
Optimal Cutoff

Abstract Background: The prognostic significance of peripheral blood-derived inflammation markers in patients with gastric cancer (GC) has not been elucidated. This study aimed to investigate the relationship between systemic inflammatory markers and GC prognosis.Methods: A prospective observational cohort study involving 598 patients was conducted to analyze the prognosis of GC based on systemic inflammatory markers. The following peripheral blood-derived inflammation markers were evaluated: the neutrophil-lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), systemic immune-inflammation index (SII), C-reactive protein/albumin (CRP/Alb) ratio, Glasgow Prognostic Score (GPS), modified Glasgow Prognostic Score (mGPS), prognostic nutrition index (PNI), and prognostic index (PI). The receiver operating characteristics (ROC) curve and the Youden index were used to determine the optimal cutoff values. Univariate and multivariate analysis of prognostic factors was conducted accordingly.Results: The optimal cutoff values of the PNI, fibrinogen, NLR, PLR, SII, and CRP/Alb were 49.5, 397ng/dl, 2.5, 154, 556, and 0.05, respectively. Multivariate analysis showed that age, PLR, TNM stage, and chemotherapy were the independent prognostic factors for advanced gastric cancer (AGC). Adjuvant chemotherapy improved the long-term prognosis of patients with PLR ≥154, but chemotherapy had no significant effect on the survival of patients with PLR <154.Conclusions: Our findings show that higher PLR (≥154) is an independent risk factor for poor prognosis in GC patients. Besides, PLR can predict adjuvant chemotherapy (oxaliplatin/5-fluorouracil combination) response in patients with GC after surgery.

scholarly journals The Glasgow Prognostic Score Before Curative Resection May Predict Postoperative Complications in Patients with Gastric Cancer

2021 ◽  
Author(s):  
Yota Shimoda ◽  
Hirohito Fujikawa ◽  
Keisuke Komori ◽  
Hayato Watanabe ◽  
Kosuke Takahashi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Postoperative Complications ◽  
Predictive Factor ◽  
Proportional Hazards Model ◽  
Prognostic Score ◽  
Surgical Techniques ◽  
Glasgow Prognostic Score ◽  
Cox Proportional Hazards Model ◽  
Stage Ii ◽  
Independent Predictive Factor

Abstract Purpose Despite improvements in surgical techniques and devices and perioperative care of gastric cancer (GC), the rate of postoperative complications still has not decreased. If patients at high risk for postoperative complications could be identified early using biomarkers, these complications might be reduced. In this study, we investigated usefulness of the preoperative Glasgow Prognostic Score (GPS) as a predictive factor for complications after surgery in patients with stage II/III GC. Methods This study retrospectively analyzed the outcomes of 424 patients who underwent curative surgery for pathological stage II/III GC from February 2007 to July 2019 at a single center. The GPS was assessed within 4 days before surgery. To identify independent risk factors for postoperative complications, univariate and multivariate analyses were performed using a Cox proportional hazards model. Results The numbers of patients with a GPS of 0, 1, and 2 were 357, 55, and 12, respectively. The rate of complications after surgery was significantly higher among patients with a GPS of 1 or 2 than among patients with a GPS of 0 (p = 0.008). Multivariate analysis identified a GPS of 1 or 2 as an independent predictive factor for postoperative complications (p = 0.037). Conclusion The preoperative GPS may be a useful predictive factor for postoperative complications in patients with stage II/III GC. Being aware of the risk of complications after surgery as indicated by the GPS before surgery may promote safe and minimally invasive surgery that we expect will improve outcomes in patients with a GPS of 1 or 2.

Inflammation-based Indexes Upon Adjuvant Chemotherapy Initiation as a Predictor of Relapse After Curative Resection of Colorectal Cancer With an Oxaliplatin-based Regimen

2022 ◽  
Vol 2 (1) ◽  
pp. 64-70
Author(s):  
MASAYA SATAKE ◽  
KAZUHIKO YOSHIMATSU ◽  
MASANO SAGAWA ◽  
HAIJIME YOKOMIZO ◽  
SHUNICHI SHIOZAWA
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Adjuvant Chemotherapy ◽  
Curative Resection ◽  
Prognostic Score ◽  
Univariate Analysis ◽  
Significant Risk ◽  
Stage Ii ◽  
Lymphocyte Ratio ◽  
Chemotherapy Initiation

Background/Aim: We investigated the clinical efficacy of inflammation-based indexes in predicting unfavourable relapse-free survival (RFS) in patients with stage II/III colorectal cancer (CRC) receiving oxaliplatin-based adjuvant chemotherapy. Patients and Methods: A retrospective analysis was performed on 45 patients who underwent curative resection for stage II/III CRC followed by oxaliplatin-based adjuvant chemotherapy after 8 weeks. Upon adjuvant chemotherapy initiation, all patients were evaluated for lymphocyte count (LC), neutrophil/lymphocyte ratio (NLR), lymphocyte/monocyte ratio (LMR), platelet/lymphocyte ratio (PLR), modified Glasgow Prognostic Score (mGPS) and prognostic nutritional index (PNI), after which their correlation with relapse was analysed. Results: Univariate analysis identified LC <1,350/mm3, NLR ≥2.03, LMR <5.15, PLR ≥209, mGPS 2, and early discontinuation of chemotherapy within two months as significant risk factors for RFS. Multivariate analysis identified LMR <5.15, PLR > 209 and mGPS 2 as significant independent risk factors for unfavourable RFS. Conclusion: Measurement of LMR, PLR, and mGPS upon adjuvant therapy initiation can be a useful tool for predicting recurrence after curative surgery for stage II/III CRC.

scholarly journals Prognostic impact of nutritional and inflammation-based risk scores in follicular lymphoma in the era of anti-CD20 targeted treatment strategies

2021 ◽  
Author(s):  
Niklas Gebauer ◽  
Britta Mengler ◽  
Svenja Kopelke ◽  
Alex Frydrychowicz ◽  
Alexander Fürschke ◽  
...  
Keyword(s):  
Follicular Lymphoma ◽  
Prognostic Score ◽  
Univariate Analysis ◽  
Prognostic Index ◽  
Glasgow Prognostic Score ◽  
Risk Scores ◽  
Study Cohort ◽  
Prognostic Impact ◽  
Who Grade ◽  
Neutrophil Lymphocyte Ratio

Abstract Background The composition of the tumor microenvironment (TME) is conditioned by immunity and the inflammatory response. Nutritional and inflammation-based risk scores have emerged as relevant predictors of survival outcome across a variety of hematological malignancies. Methods In this retrospective multicenter trial, we ascertained the prognostic impact of established nutritional and inflammation-based risk scores [Glasgow Prognostic Score (GPS), C-reactive–protein/albumin ratio (CAR), neutrophil–lymphocyte ratio (NLR), prognostic nutritional index (PNI), and prognostic index (PI)] in 209 eligible patients with histologically confirmed CD20+ follicular lymphoma (FL) of WHO grade 1 (37.3%), 1–2 (16.3%), 2 (26.8%) or 3A (19.8%) admitted to the participating centers between January 2000 and December 2019. Characteristics significantly associated with overall or progression-free survival (OS, PFS) upon univariate analysis were subsequently included in a Cox proportional hazard model. Results In the study cohort, the median age was 63 (range 22–90 years). The median follow-up period covered 99 months. The GPS and the CAR were identified to predict survival in FL patients. The GPS was the only independent predictor of OS (p < 0.0001; HR 2.773; 95% CI 1.630–4.719) and PFS (p = 0.001; HR 1.995; 95% CI 1.352–2.944) upon multivariate analysis. Additionally, there was frequent occurrence of progression of disease within 24 months (POD24) in FL patients with a calculated GPS of 2. Conclusion The current results indicate that the GPS predicts especially OS in FL patients. Moreover, GPS was found to display disease-specific effects in regard to FL progression. These findings and potential combinations with additional established prognosticators should be further validated within prospective clinical trials.

scholarly journals The values of several inflammatory markers, including the neutrophil/lymphocyte ratio, in patients with pancreatic cancer treated by curative resection followed by adjuvant chemotherapy

2017 ◽  
Author(s):  
Yusuke Nakayama ◽  
Naoto Gotohda ◽  
Shinichiro Takahashi ◽  
Masaru Konishi ◽  
Ryuichi Hayashi
Keyword(s):  
Pancreatic Cancer ◽  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Inflammatory Markers ◽  
Curative Resection ◽  
Prognostic Score ◽  
Glasgow Prognostic Score ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

Abstract Objective: The aim of this study was to determine the relationship between the values of several systemic inflammatory markers and the prognosis in pancreatic cancer patients treated by curative resection followed by adjuvant chemotherapy. Methods: A total of 110 pancreatic cancer patients who treated by curative resection followed by adjuvant chemotherapy were reviewed for this study. Univariate and multivariate analyses were performed to identify the clinicopathological factors influencing the overall survival, including the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), Glasgow prognostic score (GPS), and the direction of change of the NLR (increase or decrease) after one cycle of adjuvant chemotherapy as compared to the value recorded prior to the start of the chemotherapy. Results: A multivariate analysis identified only the direction of change of the NLR after the first cycle of adjuvant chemotherapy as an independent risk factor for the overall survival (NLR decrease vs. NLR increase, HR=1.925; P=0.044). The NLR, PLR and GPS were not identified as significant predictors of the overall survival. Conclusions: The direction of change of the NLR after the first cycle of adjuvant chemotherapy may help in predicting the effect of chemotherapy in pancreatic cancer patients treated by curative resection followed by adjuvant chemotherapy.

scholarly journals Clinical significance of peripheral blood-derived inflammation markers in advanced gastric cancer after radical resection

2020 ◽  
Author(s):  
Lihu Gu ◽  
Mian Wang ◽  
Xuena Cui ◽  
Jiahang Mo ◽  
Lingling Yuan ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Adjuvant Chemotherapy ◽  
Peripheral Blood ◽  
Inflammatory Markers ◽  
Prognostic Score ◽  
Glasgow Prognostic Score ◽  
Inflammation Markers ◽  
Optimal Cutoff

Abstract Background: The prognostic significance of peripheral blood-derived inflammation markers in patients with gastric cancer (GC) has not been elucidated. This study aimed to investigate the relationship between systemic inflammatory markers and GC prognosis.Methods: A prospective observational cohort study involving 598 patients was conducted to analyze the prognosis of GC based on systemic inflammatory markers. The following peripheral blood-derived inflammation markers were evaluated: the neutrophil-lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), systemic immune-inflammation index (SII), C-reactive protein/albumin (CRP/Alb) ratio, Glasgow Prognostic Score (GPS), modified Glasgow Prognostic Score (mGPS), prognostic nutrition index (PNI), and prognostic index (PI). The receiver operating characteristics (ROC) curve and the Youden index were used to determine the optimal cutoff values. Univariate and multivariate analysis of prognostic factors was conducted accordingly.Results: The optimal cutoff values of the PNI, fibrinogen, NLR, PLR, SII, and CRP/Alb were 49.5, 397ng/dl, 2.5, 154, 556, and 0.05, respectively. Multivariate analysis showed that age, PLR, TNM stage, and chemotherapy were the independent prognostic factors for advanced gastric cancer (AGC). Adjuvant chemotherapy improved the long-term prognosis of patients with PLR ≥154, but chemotherapy had no significant effect on the survival of patients with PLR <154.Conclusions: Our findings show that higher PLR (≥154) is an independent risk factor for poor prognosis in GC patients. Besides, PLR can predict adjuvant chemotherapy (oxaliplatin/5-fluorouracil combination) response in patients with GC after surgery.

Influence of systemic and local immune response on overall survival after hepatic resection of colorectal liver metastasis.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 756-756
Author(s):  
Takeomi Hamada ◽  
Hidenobu Ishizaki ◽  
Yukihiro Haruyama ◽  
Rouko Hamada ◽  
Takuto Ikeda ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Immune Response ◽  
T Cells ◽  
Adjuvant Chemotherapy ◽  
Prognostic Factor ◽  
Memory T Cells ◽  
Prognostic Score ◽  
Univariate Analysis ◽  
Metastatic Lesion ◽  
Local Immune Response

756 Background: Colorectal cancer progression is dependent on complex interactions between the tumor and the host. Tumor infiltrating lymphocytes (TIL) have been reported as a prognostic factor in colorectal cancer. The aim of this study was to assess the prognostic value of pre-operative systemic immune biomarkers and TIL in patients with resectable colorectal liver metastases (CLM). Methods: Clinicopathological data were reviewed for patients (n=31) who underwent hepatic resections for CLM between 2000 and 2008. Prognostic variables from the primary lesion, metastatic lesion, and host inflammatory biomarkers measured as routine pre-operative blood tests (modified Glasgow Prognostic Score and neutrophil to lymphocyte ratio [NLR]) were evaluated by univariate and multivariate analyses. To evaluate the local immune responses of resected metastatic lesion, immunohistochemical analysis was performed. The immune subsets were CD8+ T cells, CD45RO+ T cells, Fork head box p3+ (FOXP3+) T cells, and CD66b+ neutrophils. We also evaluated PD-L1 expression in the metastatic lesion. Results: The number of metastases ≥ 4, extrahepatic metastasis, adjuvant chemotherapy, and NLR > 4.1 were correlated with cancer-specific survival in univariate analysis. On multivariate analysis, the number of metastases (HR: 0.09, CI: 0.01-0.56, p=0.0102), adjuvant chemotherapy (HR: 0.08, CI: 0.01-0.39, p=0.0025), and raised NLR (HR: 0.11, CI: 0.01-0.99, p=0.0494) remained independent prognostic indicators. Accumulation of CD45RO+ memory T cells in the metastatic tumors was significantly associated with favorable survival in patients with resectable CLM (p=0.020). Interestingly, increased neutrophils in peripheral blood showed significant correlation with reduced accumulation of CD45RO+ memory T cells in metastatic lesion (p=0.023). Conclusions: Based on the present results and the existing validation literature, systemic immune response including NLR and local immune response including CD45RO+ memory T cells may be promising prognostic factor of patients with resectable CLM. Further functional analysis of neutrophils in CLM patient will be needed.

Significance as a recurrence predictor of postoperative neutrophil-lymphocyte ratio in patients with stage II/III gastric cancer: A retrospective study.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 45-45
Author(s):  
Hiroaki Tanaka ◽  
Kazuya Muguruma ◽  
Katsunobu Sakurai ◽  
Takahiro Toyokawa ◽  
Naoshi Kubo ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Lymph Node Metastasis ◽  
Peritoneal Dissemination ◽  
Stage Ii ◽  
Diffuse Type ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Node Metastasis

45 Background: Tumor markers such as carcinoembryonic antigen (CEA) and CA 19-9 are both widely used in the follow up of patients with gastric cancer. However, there are no definitive predictive markers for postopetrative recurrence. It has been reported that preoperative neutrophil lymphocyte ratio (NLR) was associated with prognosis of patients with gastrointestinal cancer. The aim of this study was to examine the impact of postoperative NLR on prediction for postoperative recurrence of gastric cancer. Methods: We retrospective reviewed data from 318 patients with Stage II/III gastric cancer who underwent curative surgical resection followed by adjuvant chemotherapy for between 2006 and 2013. Patients treated with preoperative chemotherapy or multiple cancers were excluded. Results: We found 118 recurrent diseases which mainly included 47 cases with peritoneal dissemination, 27 with distant lymph node metastasis and 24 with liver metastasis. Postoperative NLR was calculated every 6 months and the data at the time of recurrence or last survival were used for analysis. In univariate analysis, histological diffuse type, mascroscopical type 4 cancer, regional lymph node metastasis, lymphatic invasion in primary tumor, tumor diameter, elevated CEA or CA19-9, and elevated NLR were associated with poor prognosis. In multivariate analysis, we found that elevated CA19-9 and NLR were independent predictive markers. Increased NLR was associated with diffuse type, peritoneal dissemination, elevated CEA and preoperative NLR but not with adverse effect of adjuvant chemotherapy. Conclusions: The postoperative NLR might be one of the surrogate markers for recurrence after curative surgery for patients with Stage II/III gastric cancer.

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