A nomogram established by inflammatory markers predicting overall survival after radical resection of gastric cancer

Abstract Background The prognostic value of inflammatory markers have been confirmed in some tumors, this research was to explore more clinical markers and then build a reliable nomogram to predict overall survival after radical resection of gastric cancer.Methods 904 patients who underwent surgery at the First Affiliated Hospital of Anhui Medical University from January 2010 to January 2013 were included. Univariate and multivariate analyses were used to screen for prognostic risk factors. The construction of the nomogram is based on the Cox proportional hazard regression model. The construction of the new scoring model is analyzed by the receiver operator characteristic (ROC) curve and then compared with other clinical indicators.Results Multivariate analysis showed that TNM stage, CEA, the systemic immune-inflammation index (SII) and age were independent prognostic factors. The value of SII was better than other inflammatory markers. The new nomogram had a higher AUC value than TNM and other risk factors, and the C-index of the nomogram was highly consistent for evaluating survival of gastric cancer patients in the validation groups and training group.Conclusions Based on the serum markers and other clinical indicators, we developed a precise nomogram to predict the prognosis of gastric cancer patients after radical surgery. This new score system can provide effective help for surgeons and patients.

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A simple model established by blood markers predicting overall survival after radical resection of gastric cancer

10.21203/rs.2.17763/v1 ◽

2019 ◽

Author(s):

Li-xiang Zhang ◽

Zhi-jian Wei ◽

Wen-xiu Han ◽

A-Man Xu

Keyword(s):

Risk Factors ◽

Gastric Cancer ◽

Cancer Patients ◽

Characteristic Curve ◽

Training Group ◽

Radical Resection ◽

Receiver Operator Characteristic Curve ◽

Clinical Indicators ◽

Score System ◽

Gastric Cancer Patients

Abstract The prognostic prediction after radical resection of gastric cancer patients has not been well established. We aimed to establish a prognostic model based on a new score system, which included another clinical routine serum marker. Methods 904 patients who underwent surgery at the First Affiliated Hospital of Anhui Medical University from January 2010 to January 2011 were included. Univariate and multivariate analyses were used to screen for prognostic risk factors. The construction of the nomogram is based on the Cox proportional hazard regression model. The construction of the new scoring model is analyzed by the receiver operator characteristic curve (ROC curve) and then compared with other clinical indicators. Results Multivariate analysis showed that TNM stage, CEA, SII and age were independent prognostic factors. The new score system had a higher AUC value than other risk factors, and the C-index of the nomogram was highly consistent for evaluating survival of gastric cancer patients in The validation groups and training group. Conclusions Based on the serum markers and other clinical indicators, we developed a precise model to predict the prognosis of gastric cancer patients after radical surgery. This score system can provide effective help for surgeons and patients.

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Combined Neutrophil-to-Lymphocyte and Platelet-Volume-to-Platelet Ratio (NLR and PVPR Score) Represents a Novel Prognostic Factor in Advanced Gastric Cancer Patients

Journal of Clinical Medicine ◽

10.3390/jcm10173902 ◽

2021 ◽

Vol 10 (17) ◽

pp. 3902

Author(s):

Kamil Konopka ◽

Agnieszka Micek ◽

Sebastian Ochenduszko ◽

Joanna Streb ◽

Paweł Potocki ◽

...

Keyword(s):

Gastric Cancer ◽

Overall Survival ◽

Advanced Gastric Cancer ◽

Cancer Patients ◽

Inflammatory Markers ◽

Cox Regression ◽

Risk Of Death ◽

Immune System Activation ◽

Increased Risk ◽

Gastric Cancer Patients

Background: Chemotherapy is a cornerstone of treatment in advanced gastric cancer (GC) with a proven impact on overall survival, however, reliable predictive markers are missing. The role of various inflammatory markers has been tested in gastric cancer patients, but there is still no general consensus on their true clinical applicability. High neutrophil-to-lymphocyte (NLR) and low (medium)-platelets-volume-to-platelet ratio (PVPR) are known markers of unspecific immune system activation, correlating significantly with outcomes in advanced GC patients. Methods: Metastatic GC patients (N:155) treated with chemotherapy +/− trastuzumab were enrolled in this retrospective study. Pre-treatment NLR and PVPR, as well as other inflammatory markers were measured in peripheral blood. Univariate Cox regression was conducted to find markers with a significant impact on overall survival (OS) and progression-free survival (PFS). Spearman correlation and Cohen’s kappa was used to analyze multicollinearity. Multiple multivariable Cox regression models were built to study the combined impact of NLR and PVPR, as well as other known prognostic factors on OS. Results: Elevated NLR was significantly associated with increased risk of death (HR = 1.95; 95% CI: 1.17–3.24), and lower PVPR was significantly associated with improved outcomes (HR = 0.53; 95% CI: 0.32–0.90). A novel inflammatory marker, based on a combination of NLR and PVPR, allows for the classification of GC patients into three prognostic groups, characterized by median OS of 8.4 months (95% CI 5.8–11.1), 10.5 months (95% CI 8.8–12.1), and 15.9 months (95% CI 13.5–18.3). Conclusion: The NLR and PVPR score (elevated NLR and decreased PVPR) is a marker of detrimental outcome of advanced GC patients treated with chemotherapy.

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Inflammatory markers for predicting overall survival in gastric cancer patients: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0236445 ◽

2020 ◽

Vol 15 (7) ◽

pp. e0236445

Author(s):

Mi-Rae Kim ◽

A-Sol Kim ◽

Hye-In Choi ◽

Jae-Hun Jung ◽

Ji Yeon Park ◽

...

Keyword(s):

Gastric Cancer ◽

Systematic Review ◽

Overall Survival ◽

Cancer Patients ◽

Inflammatory Markers ◽

Meta Analysis ◽

Gastric Cancer Patients

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Impact of Palliative Gastrectomy in Patients with Incurable Gastric Cancer

Medicina ◽

10.3390/medicina57030198 ◽

2021 ◽

Vol 57 (3) ◽

pp. 198

Author(s):

Ji Yeon Park ◽

Byunghyuk Yu ◽

Ki Bum Park ◽

Oh Kyoung Kwon ◽

Seung Soo Lee ◽

...

Keyword(s):

Gastric Cancer ◽

Overall Survival ◽

Cancer Patients ◽

Tumor Resection ◽

Palliative Resection ◽

Primary Tumors ◽

Palliative Intent ◽

Palliative Gastrectomy ◽

Gastric Cancer Patients ◽

The Impact

Background and Objectives: The prognosis of metastatic or unresectable gastric cancer is dismal, and the benefits of the palliative resection of primary tumors with noncurative intent remain controversial. This study aimed to evaluate the impact of palliative gastrectomy (PG) on overall survival in gastric cancer patients. Materials and Methods: One hundred forty-eight gastric cancer patients who underwent PG or a nonresection (NR) procedure between January 2011 and 2017 were retrospectively reviewed to select and analyze clinicopathological factors that affected prognosis. Results: Fifty-five patients underwent primary tumor resection with palliative intent, and 93 underwent NR procedures owing to the presence of metastatic or unresectable disease. The PG group was younger and more female dominant. In the PG group, R1 and R2 resection were performed in two patients (3.6%) and 53 patients (96.4%), respectively. The PG group had a significantly longer median overall survival than the NR group (28.4 vs. 7.7 months, p < 0.001). Multivariate analyses revealed that the overall survival was significantly better after palliative resection (hazard ratio (HR), 0.169; 95% confidence interval (CI), 0.088–0.324; p < 0.001) in patients with American Society of Anesthesiologists Physical Status (ASA) scores ≤1 (HR, 0.506; 95% CI, 0.291–0.878; p = 0.015) and those who received postoperative chemotherapy (HR, 0.487; 95% CI, 0.296–0.799; p = 0.004). Among the patients undergoing palliative resection, the presence of <15 positive lymph nodes was the only significant predictor of better overall survival (HR, 0.329; 95% CI, 0.121–0.895; p = 0.030). Conclusions: PG might lead to the prolonged survival of certain patients with incurable gastric cancer, particularly those with less-extensive lymph-node metastasis.

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A novel predictive model for predicting prognostic value of preoperative blood lymphocyte-monocyte ratio in gastric cancer patients after radical resection

Annals of Oncology ◽

10.1093/annonc/mdx261.108 ◽

2017 ◽

Vol 28 ◽

pp. iii45

Author(s):

Changming Huang ◽

Jianxian Lin ◽

Jun-Peng Lin ◽

Long-Long Cao ◽

Chao-Hui Zheng

Keyword(s):

Gastric Cancer ◽

Predictive Model ◽

Cancer Patients ◽

Blood Lymphocyte ◽

Prognostic Value ◽

Radical Resection ◽

Gastric Cancer Patients

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Dual role of carcinoembryonic antigen-related cell adhesion molecule 6 expression in predicting the overall survival of gastric cancer patients

Scientific Reports ◽

10.1038/s41598-017-11482-9 ◽

2017 ◽

Vol 7 (1) ◽

Cited By ~ 3

Author(s):

Mingde Zang ◽

Lei Hu ◽

Shu Cao ◽

Zhiyuan Fan ◽

Li Pang ◽

...

Keyword(s):

Gastric Cancer ◽

Overall Survival ◽

Cell Adhesion ◽

Carcinoembryonic Antigen ◽

Cancer Patients ◽

Adhesion Molecule ◽

Cell Adhesion Molecule ◽

Related Cell ◽

Gastric Cancer Patients

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ELISA study of matrix metalloproteinases 2, 7, 9 and their type 2 tissue inhibitor in the tumors of gastric cancer patients: clinical and pathologic correlations

Almanac of Clinical Medicine ◽

10.18786/2072-0505-2018-46-4-323-329 ◽

2018 ◽

Vol 46 (4) ◽

pp. 323-329

Author(s):

E. S. Gershtein ◽

A. A. Ivannikov ◽

V. L. Chang ◽

N. A. Ognerubov ◽

М. M. Davydov ◽

...

Keyword(s):

Gastric Cancer ◽

Overall Survival ◽

Prognostic Factors ◽

Matrix Metalloproteinases ◽

Tumor Progression ◽

Cancer Patients ◽

Univariate Analysis ◽

Gastric Cancer Tissue ◽

Cancer Tissue ◽

Gastric Cancer Patients

Background: Over the last 10 years the incidence of gastric cancer has declined significantly. Nevertheless, it remains one of the most prevalent malignancies both in Russia and worldwide. Therefore, the problems of early diagnostics, prognosis and individualized treatment choice are still on the agenda. Much attention is paid to the evaluation of molecular biological characteristics of the tumor, as well as to the development of multiparametric prognostic systems for gastric cancer based on its identified characteristics. An important place among potential tumor biological markers belongs to matrix metalloproteinases (MMPs) involved into all the stages of tumor progression, first of all, into the regulation of invasion and metastasizing.Aim: Comparative quantitative evaluation of some MMP family members (MMP-2, 7, and 9) and one of the tissue MMP inhibitors (TIMP-2) levels in the tumors and adjacent histologically unchanged mucosa in gastric cancer patients, the analysis of their associations with the main clinical and pathological features of the disease and its prognosis.Materials and methods: Sixty six (66) primary gastric cancer patients (32 male and 34 female) aged 24 to 82 years (median, 61 year) were recruited into the study. Twenty two (22) patients were with stage I of the disease, 11 with stage II, 28 with stage III, and 5 with stage IV. The concentrations of the proteins studied were measured in the tumor and unchanged mucosa extracts by standard direct ELISA kits (Quantikine®, R&D Systems, USA).Results: Tumor MMP-2, 7 and 9 levels were significantly increased, compared to those in the adjacent histologically unchanged mucosa, in 80, 70 and 72% of gastric cancer patients, respectively, while the increase of TIMP-2 level found in 61% of the tumors was not statistically significant. Tumor MMP-2 and TIMP-2 content was increasing significantly with higher T index – size and advancement of the primary tumor (p < 0.01 and p < 0.05 respectively). Tumor MMP-2 level was also increasing in parallel with the N index (regional lymph node involvement; p < 0.01); it was significantly higher in the patients with distant metastases than in those without them (p < 0.05). Tumor MMP-9 and MMP-7 concentrations were not significantly associated with the indices of the tumor progression. The patients were followed up for 1 to 85 months (median, 18.3 months). According to the univariate analysis, high (> 32.6 ng/mg protein) MMP-2 and low MMP-7 (< 1.1 ng/mg protein) levels in the gastric cancer tissue represent statistically significant unfavorable prognostic factors for overall survival. Increased TIMP-2 level is associated with a non-significant decrease in the overall survival (p > 0.05), whereas the MMP-9 level was unrelated to the gastric cancer prognosis. Only T index (p = 0.0034) and tumor MMP-7 content (p = 0.026) remained independent prognostic factors in the multivariate regression analysis.Conclusion: The majority of gastric cancer patients demonstrate a significant increase in the expression of three MMP family members, i.e. gelatinases (MMP-2 and 9), and matrilysin (MMP-7), in the tumors, as compared to adjacent histologically unchanged mucosa. Only MMP-2 levels were associated with the disease progression, increasing with higher TNM system indices. High MMP-2 and low MMP-7 content in the gastric cancer tissue are significant unfavorable prognostic factors for the overall survival in the univariate analysis, but only MMP-7 has retained its independent prognostic value in the multivariate assessment.

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Efficacy and Safety of FLOT regimen vs. DCF, FOLFOX, and ECF regimens as Perioperative Chemotherapy Treatments for Resectable Gastric Cancer Patients

10.1101/2021.01.26.21250550 ◽

2021 ◽

Author(s):

Pegah Farrokhi ◽

Alireza Sadeghi ◽

Mehran sharifi ◽

Payam Dadvand ◽

Rachel Riechelmann ◽

...

Keyword(s):

Gastric Cancer ◽

Overall Survival ◽

Cancer Patients ◽

Cox Regression ◽

Progression Free Survival ◽

R0 Resection ◽

P Value ◽

Perioperative Chemotherapy ◽

Resectable Gastric Cancer ◽

Gastric Cancer Patients

AbstractAimThis study aimed to evaluate and compare the efficacy and toxicity of common regimens used as perioperative chemotherapy including ECF, DCF, FOLFOX, and FLOT to identify the most effective chemotherapy regimen with less toxicity.Material and MethodsThis retrospective cohort study was based on 152 eligible gastric cancer patients recruited in a tertiary oncology hospital in Isfahan, Iran (2014-2019). All resectable gastric cancer patients who had received one of the four chemotherapy regimens including ECF, DCF, FOLFOX, or FLOT, and followed for at least one year (up to five years) were included. The primary endpoint of this study was Overall Survival (OS), Progression-Free Survival (PFS), Overall Response Rate (ORR), and R0 resection. We also considered toxicity according to CTCAE (v.4.0) criteria as a secondary endpoint. Cox -regression models were used applied to estimate OS and PFS time, controlled for relevant covariates.ResultsOf included patients, 32(21%), 51(33.7%), 37(24.3%), and 32(21%) had received ECF, DCF, FOLFOX and FLOT, respectively. After the median 25 months follow-up, overall survival was higher with the FLOT regimen in comparison with other regimens (hazard ratio [HR] = 0. 052). The median OS of the FLOT regimen was not reachable in Kaplan-Meier analysis and the median OS was 28, 26, and 23 months for DCF, FOLOFX, and ECF regimens, respectively. On the other hand, a median PFS of 25, 17, 15, and 14 months was observed for FLOT, DCF, FOLFOX, and ECF regimens, respectively (Log-rank = 0. 021). FLOT regimen showed 84. 4% ORR which was notably higher than other groups (p-value<0. 01).ConclusionsFor resectable gastric cancer patients, the perioperative FLOT regimen seemed to lead to a significant improvement in patients’ OS and PFS in comparison with ECF, DCF, and FOLFOX regimens. As such, the FLOT regimen could be considered as the optimal option for managing resectable gastric cancer patients.

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