Skip to main content

Advertisement

Log in

New prognostic western score predicting survival after curative resection of gastric cancer

  • Original Article
  • Published:
Updates in Surgery Aims and scope Submit manuscript

Abstract

The aim of our study was to develop a prognostic score for gastric cancer patients who underwent R0 resection with curative intent, to identify high-risk patients. Three thirty three patients curatively operated for gastric adenocarcinoma were enrolled in the study. To define our prognostic score pre-operative inflammation sieric markers such as neutrophil to lymphocytes ratio, platelet count, platelet to lymphocytes ratio, and other clinical pathological and surgical characteristics of our patients such as albumin preoperative level, CRP sieric level, hystological Lauren’s subtype, tumor location, lymphonodal status were analyzed. Prognostic factors predicting OS were analyzed using Cox proportional hazards models and a prognostic score was built. 5Y-OS was 42% with a median survival of 41 months. The multivariate analysis identified four independent prognostic factors: preoperative albumin level (HR 2.5), preoperative N/L ratio (HR 2.4), Diffuse Lauren histological subtype (HR 1.5) and TNM stage III and IV (HR 1.2). According to the relative risk of each variable we construct a prognostic score and validated it internally. Four risk classes were built and patients were statistically different stratifying according to them. More important the stratification was maintained also when patients were subdivided according to the pathological stage. In summary, we were able to construct a prognostic score that could be easily used in all the clinical contests, being it cheap and prompt. Our results, however, need to be externally validated, by a major center to be introduced into the clinical practice.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 68:394–424

    Article  Google Scholar 

  2. Siegel RL, Miller KD, Jemal A (2016) Cancer statistics 2016 CA. Cancer J Clin 66(1):7–30

    Article  Google Scholar 

  3. Amin MB, Edge S, Greene FL et al (2017) AJCC cancer staging manual (M), 8th edn. Springer, New York, pp 185–202

    Book  Google Scholar 

  4. Shao Y, Geng Y, Gu W et al (2016) Assessment of lymph node ratio to replace the pn categories system of classification of the tnm system in esophageal squamous cell carcinoma. J Thorac Oncol 11(10):1774–1784

    Article  Google Scholar 

  5. Ahn H-S, Sohn TS, Kim MJ, Cho BK, Kim SM, Kim ST, Yi EC, Lee C (2018) SEPROGADIC: serum protein- based gastric cancer prediction model for prognosis and selection of proper adjuvant therapy. Sci Rep 8:16892

    Article  Google Scholar 

  6. Hanahan D, Weinberg RA (2011) Hallmarks of cancer: the next generation. Cell 144(5):646–674

    Article  CAS  Google Scholar 

  7. Labelle M, Begum S, Hynes RO (2011) Direct signalingbetween platelets and cancer cells induces an epithelialmesenchymal-like transition and promotes metastasis. Cancer Cell 20(5):576–590

    Article  CAS  Google Scholar 

  8. Cools-Lartigue J, Spicer J, McDonald B et al (2013) Neutrophil extracellular traps sequester circulating tumor cells and promote metastasis. J Clin Investig 123(8):3446–3458

    Article  CAS  Google Scholar 

  9. Graziosi L, Marino E, De Angelis V, Rebonato A, Cavazzoni E, Donini A (2015) Prognostic value of preoperative neutrophils to lymphocytes ratio in patients resected for gastric cancer. Am J Surg 209:333–337

    Article  Google Scholar 

  10. Lu J, Cao LL, Li P, Xie JW, Wang JB, Lin JX, Chen QY, Lin M, Tu RH, Huang CM, Zheng CH (2018) Significance of preoperative systemic immune score for stage I gastric cancer patients. Gastroenterol Res Pract 2018:3249436

    PubMed  PubMed Central  Google Scholar 

  11. Lee, Su Y, Hung S et al (2017) Recommendation for incorporation of a different lymph node scoring system in future AJCC N category for oral cancer. Sci Rep 7:14117. https://doi.org/10.1038/s41598-017-06452-0

  12. Thomassen I, van Gestel YR, van Ramshorst B, Luyer MD, Bosscha K, Nienhuijs SW, Lemmens VE, de Hingh IH (2014) Peritoneal carcinomatosis of gastric origin: a population-based study on incidence, survival and risk factors. Int J Cancer 134:622–628 (VC 2013 UICC)

    Article  CAS  Google Scholar 

  13. Balkwill F, Mantovani A (2001) Inflammation and cancer: back to virchow? Lancet 357(9255):539–545

    Article  CAS  Google Scholar 

  14. Greten FR, Grivennikov SI (2019) Inflammation and cancer: triggers, mechanisms, and consequences. Immunity 51(1):27–41

    Article  CAS  Google Scholar 

  15. Yongzhong Wu, Antony S, Meitzler JL, Doroshow JH (2014) Molecular mechanisms underlying chronic inflammation- associated cancersCinzia Milito. Cancer Lett 345(2):164–173

    Article  Google Scholar 

  16. Suzuki Y, Okabayashi K, Hasegawa H et al (2018) Comparison of pre- operative inflammation-based prognostic scores in patients with colorectal cancer. Ann Surg 267(3):527–531

    Article  Google Scholar 

  17. Chang Y, An H, Xu L et al (2015) Systemic inflammation score predicts postoperative prognosis of patients with clear-cell renal cell car- cinoma. Br J Cancer 113(4):626–633

    Article  CAS  Google Scholar 

  18. Sato B, Kanda M, Tanaka C, et al. (2018) Significance of preoperative systemic inflammation score in short-term and long-term out- comes of patients with pathological T2–4 gastric cancer after radical gastrectomy. World J Surg 42(10):3277–3285

  19. Lin JX, Lin JP, Xie JW et al (2019) Prognostic importance of the preoperative modified systemic inflammation score for patients with gastric cancer. Gastric Cancer 22:403

    Article  CAS  Google Scholar 

  20. Zhu GS, Tian SB (2018) Preoperative neutrophil lymphocyte ratio and platelet lymphocyte ratio cannot predict lymph node metastasis and prognosis in patients with early gastric cancer: a single institution investigation in China. Curr Med Sci 38(1):78–84

    Article  CAS  Google Scholar 

  21. Maletzki C, Emmrich J (2010) Inflammation and immunity in the tumor environment. Dig Dis 28(4–5):574–578

    Article  CAS  Google Scholar 

  22. McMillan DC (2009) Systemic inflammation, nutritional status and survival in patients with cancer. Curr Opin Clin Nutr Metab Care 12(3):223–226

    Article  Google Scholar 

  23. Gupta D, Lis CG (2010) Pretreatment serum albumin as a predictor of cancer survival: a systematic review of the epidemiological literature. Nutr J 9:69

    Article  Google Scholar 

  24. Di Fiore F, Lecleire S, Pop D, Rigal O, Hamidou H, Paillot B, Ducrotte P, Lerebours E, Michel P (2007) Baseline nutritional status is predictive of response to treatment and survival in patients treated by definitive chemoradiotherapy for a locally advanced esophageal cancer. Am J Gastroenterol 102:2557–2563

    Article  Google Scholar 

  25. Lien YC, Hsieh CC, Wu YC, Hsu HS, Hsu WH, Wang LS, Huang MH, Huang BS (2004) Preoperative serum albumin level is a prognostic indicator for adenocarcinoma of the gastric cardia. J Gastrointest Surg 8:1041–1048

    Article  Google Scholar 

  26. Lee J, Lim T, Uhm JE, Park KW, Park SH, Lee SC, Park JO, Park YS, Lim HY, Sohn TS et al (2007) Prognostic model to predict survival following first-line chemotherapy in patients with metastatic gastric adenocarcinoma. Ann Oncol 18:886–891

    Article  CAS  Google Scholar 

  27. Sachlova M, Majek O, Tucek S (2014) Prognostic value of scores based on malnutrition or systemic inflammatory response in patients with metastatic or recurrent gastric cancer. Nutr Cancer 66:1362–1370

    Article  CAS  Google Scholar 

  28. Graziosi L, Marino E, Donini A (2019) Survival comparison in gastric cancer patients between 7th and 8th edition of the AJCC TNMstaging system: the first western single center experience. Eur J Surg Oncol 45(6):1105–1108

    Article  CAS  Google Scholar 

Download references

Funding

No founding was accepted for this paper.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Graziosi Luigina.

Ethics declarations

Conflict of interest

All the authors have no conflict of interest to declare

Ethical standards

Ethical standards have been respected, according to the Helsinki’s declaration

Informed Consent

All the patients were enrolled according to our Istitution policy previous a written consens form. Data were analyzed anonimously.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Luigina, G., Elisabetta, M., Cristina, V.M. et al. New prognostic western score predicting survival after curative resection of gastric cancer. Updates Surg 72, 1023–1030 (2020). https://doi.org/10.1007/s13304-020-00835-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13304-020-00835-1

Navigation