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Comparison of Inflammation-Based Prognostic Scores Associated with the Prognostic Impact of Adenocarcinoma of Esophagogastric Junction and Upper Gastric Cancer

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Several inflammation-based prognostic scores have a prognostic value in patients with various cancers. This study investigated the prognostic value of various inflammation-based prognostic scores in patients who underwent a surgery for adenocarcinoma of the esophagogastric junction (AEG) and upper gastric cancer (UGC).

Methods

We reviewed data of 206 patients who underwent surgery for AEG and UGC. We calculated neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), Glasgow Prognostic Score (GPS), modified GPS (mGPS), C-reactive protein (CRP)/albumin (Alb) ratio, prognostic index (PI), and prognostic nutritional index (PNI) and analyzed the relationship between these biomarkers and postoperative prognosis.

Results

In multivariate analyses for overall survival, mGPS (P = 0.0337, hazard ratio [HR] = 5.211), PI (P = 0.0002, HR = 21.20), and PNI (P < 0.0001, HR = 6.907) were identified as independent predictive factors. A multivariate analysis for recurrence-free survival showed that only PI (P = 0.0006, HR = 11.89) and PNI (P = 0.0002, HR = 4.972) were independent predictive factors among the above-mentioned inflammation-based prognostic scores.

Conclusions

In various inflammation-based prognostic scores, PI and PNI were more strongly associated with poor prognosis in patients who underwent surgery for AEG and UGC.

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Acknowledgment

The authors thank Editage Group (https://www.editage.jp/) for editing the draft of this manuscript.

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Authors and Affiliations

  1. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Kensuke Kudou MD, PhD, Yuichiro Nakashima MD, PhD, Yasuhiro Haruta MD, Sho Nambara MD, PhD, Yasuo Tsuda MD, PhD, Koji Ando MD, PhD, Yasue Kimura MD, PhD, Kenkichi Hashimoto MD, PhD, Keiji Yoshinaga MD, PhD, Hiroshi Saeki MD, PhD, FACS, Eiji Oki MD, PhD, FACS, Yoshihisa Sakaguchi MD, PhD, Tetsuya Kusumoto MD, PhD, Koji Ikejiri MD, PhD & Masaki Mori MD, PhD, FACS

  2. Department of Gastroenterological Surgery, Clinical Research Institute Cancer Research Division, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan

    Kensuke Kudou MD, PhD, Sho Nambara MD, PhD, Yasuo Tsuda MD, PhD, Eiji Kusumoto MD, Kenkichi Hashimoto MD, PhD, Keiji Yoshinaga MD, PhD, Yoshihisa Sakaguchi MD, PhD, Tetsuya Kusumoto MD, PhD & Koji Ikejiri MD, PhD

  3. Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Japan

    Hiroshi Saeki MD, PhD, FACS

  4. Department of Biostatistics, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan

    Mototsugu Shimokawa PhD

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  1. Kensuke Kudou MD, PhD
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  2. Yuichiro Nakashima MD, PhD
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Correspondence to Kensuke Kudou MD, PhD.

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Ethical Standards

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions.

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10434_2020_8821_MOESM1_ESM.tif

Supplementary Fig. 1. Comparison of the predictive ability of seven inflammation-based prognostic scores—NLR, PLR, GPS, mGPS, CRP/Alb ratio, PI, and PNI—by receiver operating characteristic (ROC) curve analyses. NLR neutrophil–lymphocyte ratio; PLR platelet-lymphocyte ratio; GPS Glasgow prognostic score; mGPS modified Glasgow prognostic score; CRP C-reactive protein; Alb albumin; PI prognostic index; PNI prognostic nutritional index (TIFF 29297 kb)

10434_2020_8821_MOESM2_ESM.tif

Supplementary Fig. 2 Comparison of the predictive ability of seven inflammation-based prognostic scores—NLR, PLR, GPS, mGPS, CRP/Alb ratio, PI, and PNI—by time-dependent receiver operating characteristic (ROC) curve analyses for (a) recurrence-free survival and (b) overall survival. NLR neutrophil–lymphocyte ratio; PLR platelet-lymphocyte ratio; GPS Glasgow prognostic score; mGPS modified Glasgow prognostic score; CRP C-reactive protein; Alb albumin; PI prognostic index; PNI prognostic nutritional index (TIFF 29297 kb)

10434_2020_8821_MOESM3_ESM.tif

Supplementary Fig. 3 Postoperative survival in patients with AEG and UGC based on prognostic index (PI). The Kaplan–Meier method was performed separately by tumor location. (a) Recurrence-free and (b) overall survival in patients with AEG. (c) Recurrence-free and (d) overall survival in patients with UGC. Kaplan–Meier analyses were performed according to the same criteria as in Fig. 1. AEG adenocarcinoma of esophagogastric junction; UGC upper gastric cancer; PI prognostic index(TIFF 29297 kb)

10434_2020_8821_MOESM4_ESM.tif

Supplementary Fig. 4 Postoperative survival in patients with AEG based on prognostic index (PI). The Kaplan–Meier method was performed separately by tumor location according to Siewert classification. (a) Recurrence-free and (b) overall survival in patients with Siewert type I. (c) Recurrence-free and (d) overall survival in patients with Siewert type II. (e) Recurrence-free and (f) overall survival in patients with Siewert type III. Kaplan–Meier analyses were performed according to the same criteria as in Fig. 1. AEG adenocarcinoma of esophagogastric junction; PI prognostic index (TIFF 29297 kb)

10434_2020_8821_MOESM5_ESM.tif

Supplementary Fig. 5 Postoperative survival in patients with AEG and UGC based on prognostic nutritional index (PNI). The Kaplan–Meier method was performed separately by tumor location. (a) Recurrence-free and (b) overall survival in patients with AEG. (c) Recurrence-free and (d) overall survival in patients with UGC. Kaplan–Meier analyses were performed according to the same criteria as in Fig. 2. AEG adenocarcinoma of esophagogastric junction; UGC upper gastric cancer; PNI prognostic nutritional index (TIFF 29297 kb)

10434_2020_8821_MOESM6_ESM.tif

Supplementary Fig. 6 Postoperative survival in patients with AEG based on prognostic nutritional index (PNI). The Kaplan–Meier method was performed separately by tumor location according to Siewert classification. (a) Recurrence-free and (b) overall survival in patients with Siewert type I. (c) Recurrence-free and (d) overall survival in patients with Siewert type II. (e) Recurrence-free and (f) overall survival in patients with Siewert type III. Kaplan–Meier analyses were performed according to the same criteria as in Fig. 2. AEG adenocarcinoma of esophagogastric junction; PNI prognostic nutritional index (TIFF 29297 kb)

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Kudou, K., Nakashima, Y., Haruta, Y. et al. Comparison of Inflammation-Based Prognostic Scores Associated with the Prognostic Impact of Adenocarcinoma of Esophagogastric Junction and Upper Gastric Cancer. Ann Surg Oncol 28, 2059–2067 (2021). https://doi.org/10.1245/s10434-020-08821-y

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