scholarly journals Significance of the Glasgow Prognostic Score in Predicting the Postoperative Outcome of Patients with Stage III Gastric Cancer

2019 ◽  
Vol 8 (9) ◽  
pp. 1448 ◽  
Author(s):  
Shun-Wen Hsueh ◽  
Keng-Hao Liu ◽  
Chia-Yen Hung ◽  
Yung-Chia Kuo ◽  
Chun-Yi Tsai ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Postoperative Complications ◽  
Prognostic Score ◽  
Glasgow Prognostic Score ◽  
Stage Iii ◽  
Survival Outcomes ◽  
Complication Rates ◽  
Term Survival ◽  
D2 Gastrectomy ◽  
Admission Rates

This study aimed at investigating the ability of a preoperative Glasgow prognostic score (GPS) to predict postoperative complications and survival outcomes in patients with stage III gastric cancer undergoing D2 gastrectomy. We retrospectively reviewed data from 272 such patients, treated between 2010 and 2016, at a Taiwanese medical center. The patients were categorized according to their GPS. In total, 36.8%, 48.5%, and 14.7% of the patients were assigned to groups with a GPS of 0, 1, and 2, respectively. Overall surgical complication rates in these groups were 30%, 45.5%, and 52.5% (p = 0.016); postoperative intensive care unit admission rates were 10%, 14.4%, and 22.5% (p = 0.15); postoperative 30-day re-admission rates were 6%, 15.2%, and 20% (p = 0.034); and the in-hospital mortality rates were 1.0%, 1.5%, and 10.0%, respectively (p = 0.006). The median survival times of the patients were 42.9 months (95% confidence interval [CI], 29.1–56.6), 22.6 months (95% CI, 19.3–25.8), and 16.6 months (95% CI, 7.8–25.4), respectively (p< 0.001). A significant correlation was observed between the preoperative GPS, short-term postoperative complications, and long-term survival outcomes in patients with gastric cancer undergoing D2 gastrectomy. These findings recommend the usage of the GPS as a predictive and prognostic factor in patients with gastric cancer considering surgical resection.

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.

Sarcopenia with modified Glasgow prognostic score as a predictor of long-term survival in patients with gastric cancer.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 27-27
Author(s):  
Masaaki Nishi ◽  
Mitsuo Shimada ◽  
Kozo Yoshikawa ◽  
Jun Higashijima ◽  
Toshihiro Nakao ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Prognostic Score ◽  
Prognostic Index ◽  
Glasgow Prognostic Score ◽  
Disease Free Survival ◽  
Term Survival ◽  
Poor Prognostic Factor ◽  
Long Term Survival ◽  
Neutrophil Lymphocyte Ratio

27 Background: Recent reports suggested that the Glasgow prognostic score (GPS), which is a preoperatively determined inflammation-based score, correlated with long -term survival in several types of cancers. The aim of this study is to create new prognostic index which is superior to modified GPS (mGPS) in gastric cancer. Methods: Seventy five patients with gastric cancer who underwent gastrectomy were enrolled in this study. Prognostic factors were searched for among clinocopathological factors and nutritional- or immune- parameters, including mGPS (J Gastoenterol 2011), neutrophil lymphocyte ratio (NLR), prognostic nutritional index (PNI), or sarcopenia. Cut of value were 3.0: NLR, 40: PNI, respectively. Sarcopenia was assessed by the following CT-based methods (Lancet 2011). Sarcopenia with mGPS (SarcoGPS) were defined as CRP was changed to sarcopenia. Results: The overall survival (OS) rate was significantly lower in mGPS:0 group than in mGPS:1,2 group (p < 0.05). The disease-free survival (DFS) rate didn’t differ in mGPS (N.S). The OS and DFS rate of high NLR group or sarcopenia group were significantly lower than those of low NLR group or non- sarcopenia group (p < 0.05). PNI did not differ significantly both in OS and DFS. SarcoGPS was the poor prognostic factor both in OS and DFS (p < 0.01) Conclusions: SarcoGPS is the new prognostic index, which is superior to mGPS, in gastric cancer.

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 promotes safe and minimally invasive surgery that we expect will improve outcomes in these patients.

scholarly journals Role of Inflammatory and Immune-Nutritional Prognostic Markers in Patients Undergoing Surgical Resection for Biliary Tract Cancers

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3594
Author(s):  
Simone Conci ◽  
Tommaso Campagnaro ◽  
Elisa Danese ◽  
Ezio Lombardo ◽  
Giulia Isa ◽  
...  
Keyword(s):  
Biliary Tract ◽  
Cox Regression ◽  
Prognostic Score ◽  
Prognostic Index ◽  
Glasgow Prognostic Score ◽  
Postoperative Mortality ◽  
Prognostic Nutritional Index ◽  
Term Survival ◽  
Lymphocyte Ratio

The relationship between immune-nutritional status and tumor growth; biological aggressiveness and survival, is still debated. Therefore, this study aimed to evaluate the prognostic performance of different inflammatory and immune-nutritional markers in patients who underwent surgery for biliary tract cancer (BTC). The prognostic role of the following inflammatory and immune-nutritional markers were investigated: Glasgow Prognostic Score (GPS), modified Glasgow Prognostic Score (mGPS), Prognostic Index (PI), Neutrophil to Lymphocyte ratio (NLR), Platelet to Lymphocyte ratio (PLR), Lymphocyte to Monocyte ratio (LMR), Prognostic Nutritional Index (PNI). A total of 282 patients undergoing surgery for BTC were included. According to Cox regression and ROC curves analysis for survival, LMR had the best prognostic performances, with hazard ratio (HR) of 1.656 (p = 0.005) and AUC of 0.652. Multivariable survival analysis identified the following independent prognostic factors: type of BTC (p = 0.002), T stage (p = 0.014), N stage (p < 0.001), histological grading (p = 0.045), and LMR (p = 0.025). Conversely, PNI was related to higher risk of severe morbidity (p < 0.001) and postoperative mortality (p = 0.005). In conclusion, LMR appears an independent prognostic factor of long-term survival, whilst PNI seems associated with worse short-term outcomes.

scholarly journals Survival analysis of elderly patients over 65 years old with stage II/III gastric cancer treated with adjuvant chemotherapy after laparoscopic D2 gastrectomy: a retrospective cohort study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yanrui Liang ◽  
Liying Zhao ◽  
Hao Chen ◽  
Tian Lin ◽  
Tao Chen ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cohort Study ◽  
Adjuvant Chemotherapy ◽  
Elderly Patients ◽  
Retrospective Cohort ◽  
Stage Iii ◽  
Rank Test ◽  
Oral Capecitabine ◽  
D2 Gastrectomy ◽  
Log Rank Test

Abstract Background The benefits of adjuvant chemotherapy for elderly patients with gastric cancer (GC) remain unknown because elderly patients are underrepresented in most clinical trials. This study aimed to evaluate the effectiveness and complications of adjuvant chemotherapy in patients > 65 years of age after laparoscopic D2 gastrectomy. Methods This was a single-center retrospective cohort study of elderly patients (> 65 years) with stage II/III GC who underwent curative laparoscopic D2 gastrectomy with R0 resection between 2004 and 2018. The adjuvant chemotherapy regimens included monotherapy (oral capecitabine) and doublet chemotherapy (oral capecitabine plus intravenous oxaliplatin [XELOX] or intravenous oxaliplatin, leucovorin, and 5-fluorouracil [FOLFOX]). The data were retrieved from a prospectively registered database maintained at the Department of General Surgery in Nanfang Hospital, China. The patients were divided as surgery alone and surgery plus adjuvant chemotherapy (chemo group). The overall survival (OS), disease-free survival (DFS), chemotherapy duration, and toxicity were examined. Results There were 270 patients included: 169 and 101 in the surgery and chemo groups, respectively. There were 10 (10/101) and six (6/101) patients with grade 3+ non-hematological and hematological adverse events. The 1−/3−/5-year OS rates of the surgery group were 72.9%/51.8%/48.3%, compared with 90.1%/66.4%/48.6% for the chemo group (log-rank test: P = 0.018). For stage III patients, the 1−/3−/5-year OS rates of the surgery group were 83.7%/40.7%/28.7%, compared with 89.9%/61.2%/43.6% for the chemo group (log-rank test: P = 0.015). Adjuvant chemotherapy was significantly associated with higher OS (HR = 0.568, 95%CI: 0.357–0.903, P = 0.017) and DFS (HR = 0.511, 95%CI: 0.322–0.811, P = 0.004) in stage III patients. Conclusions This study suggested that adjuvant chemotherapy significantly improves OS and DFS compared with surgery alone in elderly patients with stage III GC after D2 laparoscopic gastrectomy, with a tolerable adverse event profile.

scholarly journals Impact of the Number of Dissected Lymph Nodes on Survival for Gastric Cancer after Distal Subtotal Gastrectomy

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Chang-Ming Huang ◽  
Jian-Xian Lin ◽  
Chao-Hui Zheng ◽  
Ping Li ◽  
Jian-Wei Xie ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Survival Rate ◽  
Lymph Nodes ◽  
Distal Gastrectomy ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Prognostic Impact ◽  
Term Survival

Objectives. To investigate the prognostic impact of the number of dissected lymph nodes (LNs) in gastric cancer after curative distal gastrectomy.Methods. The survival of 634 patients who underwent curative distal gastrectomy from 1995 to 2004 was retrieved. Long-term surgical outcomes and associations between the number of dissected LNs and the 5-year survival rate were investigated.Results. The number of dissected LNs was one of the most important prognostic indicators. Among patients with comparable T category, the larger the number of dissected LNs was, the better the survival would be (). The linear regression showed that a significant survival improvement based on increasing retrieved LNs for stage II, III and IV (). A cut-point analysis yields the greatest variance of survival rate difference at the levels of 15 LNs (stage I), 25 LNs (stage II) and 30 LNs (stage III).Conclusion. The number of dissected LNs is an independent prognostic factor for gastric cancer. To improve the long-term survival of patients with gastric cancer, removing at least 15 LNs for stage I, 25 LNs for stage II, and 30 LNs for stage III patients during curative distal gastrectomy is recommended.

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