Erschienen in:
29.10.2019 | Original Article
Preoperative total cholesterol-lymphocyte score as a novel immunonutritional predictor of survival in gastric cancer
verfasst von:
Daiki Matsubara, Katsutoshi Shoda, Takeshi Kubota, Toshiyuki Kosuga, Hirotaka Konishi, Atsushi Shiozaki, Hitoshi Fujiwara, Kazuma Okamoto, Michihiro Kudou, Tomohiro Arita, Ryo Morimura, Yasutoshi Murayama, Hisashi Ikoma, Yoshiaki Kuriu, Masayoshi Nakanishi, Eigo Otsuji
Erschienen in:
Langenbeck's Archives of Surgery
|
Ausgabe 6/2019
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Abstract
Purpose
Immunonutritional status is a known prognostic correlate in the context of gastric cancer (GC). In the present study, we investigated the prognostic relevance of a lipid profile-based immunonutritional score in patients with GC.
Methods
Data pertaining to 224 patients with stage II and III GC who underwent curative gastrectomy were retrospectively analyzed. The total cholesterol-lymphocyte score (TL score) was defined as follows: patients with both low total cholesterol (TC) and total lymphocyte count were allocated a score of 2; patients with only one or none of these biochemical abnormalities were allocated a score of 1 or 0, respectively.
Results
Among the serum lipid indices, low TC was the strongest predictor of cancer-specific survival (CSS; p = 0.001). On multivariate analysis, both low prognostic nutritional index (PNI) (p < 0.001) and high TL score (p = 0.003) were independent prognostic factors. PNI was significantly associated with peritoneal recurrence (p = 0.047), while TL score was significantly associated with locoregional and distant metastasis (p = 0.004 and p = 0.003, respectively).
Conclusions
TL score may facilitate risk stratification of patients based on CSS. TL score plus PNI may help predict the recurrence pattern in patients with stage II and III GC.