AIM: To assess the prognostic significance of immunological and nutritional-based indices, including the prognostic nutritional index (PNI), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio in gastric cancer. METHODS: We retrospectively reviewed 632 gastric cancer patients who underwent gastrectomy between 1998 and 2008. Areas under the receiver operating characteristic curve were calculated to compare the predictive ability of the indices, together with estimating the sensitivity, specificity and agreement rate. Univariate and multivariate analyses were performed to identify risk factors for overall survival (OS). Propensity score analysis was performed to adjust variables to control for selection bias. RESULTS: Each index could predict OS in gastric cancer patients in univariate analysis, but only PNI had independent prognostic significance in multivariate analysis before and after adjustment with propensity scoring (hazard ratio, 1.668; 95% confidence interval: 1.368-2.035). In subgroup analysis, a low PNI predicted a significantly shorter OS in patients with stage II-III disease (P = 0.019, P < 0.001), T3-T4 tumors (P < 0.001), or lymph node metastasis (P < 0.001). Canton score, a combination of PNI, NLR, and platelet, was a better indicator for OS than PNI, with the largest area under the curve for 12-, 36-, 60-mo OS and overall OS (P = 0.022, P = 0.030, P < 0.001, and P = 0.024, respectively). The maximum sensitivity, specificity, and agreement rate of Canton score for predicting prognosis were 84.6%, 34.9%, and 70.1%, respectively. CONCLUSION: PNI is an independent prognostic factor for OS in gastric cancer. Canton score can be a novel preoperative prognostic index in gastric cancer.
AIM: To assess the prognostic significance of immunological and nutritional-based indices, including the prognostic nutritional index (PNI), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio in gastric cancer. METHODS: We retrospectively reviewed 632 gastric cancerpatients who underwent gastrectomy between 1998 and 2008. Areas under the receiver operating characteristic curve were calculated to compare the predictive ability of the indices, together with estimating the sensitivity, specificity and agreement rate. Univariate and multivariate analyses were performed to identify risk factors for overall survival (OS). Propensity score analysis was performed to adjust variables to control for selection bias. RESULTS: Each index could predict OS in gastric cancerpatients in univariate analysis, but only PNI had independent prognostic significance in multivariate analysis before and after adjustment with propensity scoring (hazard ratio, 1.668; 95% confidence interval: 1.368-2.035). In subgroup analysis, a low PNI predicted a significantly shorter OS in patients with stage II-III disease (P = 0.019, P < 0.001), T3-T4 tumors (P < 0.001), or lymph node metastasis (P < 0.001). Canton score, a combination of PNI, NLR, and platelet, was a better indicator for OS than PNI, with the largest area under the curve for 12-, 36-, 60-mo OS and overall OS (P = 0.022, P = 0.030, P < 0.001, and P = 0.024, respectively). The maximum sensitivity, specificity, and agreement rate of Canton score for predicting prognosis were 84.6%, 34.9%, and 70.1%, respectively. CONCLUSION: PNI is an independent prognostic factor for OS in gastric cancer. Canton score can be a novel preoperative prognostic index in gastric cancer.
Entities:
Keywords:
Canton score; Gastric cancer; Neutrophil-lymphocyte ratio; Platelet-lymphocyte ratio; Prognosis; Prognostic nutritional index
Authors: Richard A Smith; Lorraine Bosonnet; Michael Raraty; Robert Sutton; John P Neoptolemos; Fiona Campbell; Paula Ghaneh Journal: Am J Surg Date: 2008-07-17 Impact factor: 2.565
Authors: Khaled M Sarraf; Elizabeth Belcher; Evgeny Raevsky; Andrew G Nicholson; Peter Goldstraw; Eric Lim Journal: J Thorac Cardiovasc Surg Date: 2008-08-29 Impact factor: 5.209
Authors: Amika Moro; Rittal Mehta; Kota Sahara; Diamantis I Tsilimigras; Anghela Z Paredes; Ayesha Farooq; J Madison Hyer; Itaru Endo; Feng Shen; Alfredo Guglielmi; Luca Aldrighetti; Matthew Weiss; Todd W Bauer; Sorin Alexandrescu; George A Poultsides; Shishir K Maithel; Hugo P Marques; Guillaume Martel; Carlo Pulitano; Olivier Soubrane; Bas G Koerkamp; Kazunari Sasaki; Timothy M Pawlik Journal: Ann Surg Oncol Date: 2020-03-20 Impact factor: 5.344
Authors: Charles S Fuchs; Kei Muro; Jiri Tomasek; Eric Van Cutsem; Jae Yong Cho; Sang-Cheul Oh; Howard Safran; György Bodoky; Ian Chau; Yasuhiro Shimada; Salah-Eddin Al-Batran; Rodolfo Passalacqua; Atsushi Ohtsu; Michael Emig; David Ferry; Kumari Chandrawansa; Yanzhi Hsu; Andreas Sashegyi; Astra M Liepa; Hansjochen Wilke Journal: J Gastric Cancer Date: 2017-06-16 Impact factor: 3.720