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23.08.2017 | Original Article

The prognostic significance of inflammation-based markers in patients with recurrent gastric cancer

verfasst von: Kazuhiro Migita, Sohei Matsumoto, Kohei Wakatsuki, Masahiro Ito, Tomohiro Kunishige, Hiroshi Nakade, Mutsuko Kitano, Mitsuhiro Nakatani, Masayuki Sho

Erschienen in: Surgery Today

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Abstract

Purpose

The aim of this study was to evaluate the prognostic impact of inflammation-based markers, including the neutrophil-to-lymphocyte ratio (NLR) and prognostic nutritional index (PNI), in patients with recurrent gastric cancer (RGC).

Methods

This study reviewed 167 patients with RGC. A receiver operating characteristics (ROC) curve analysis was performed to determine the NLR and PNI cutoff values. The prognostic significance of the NLR and PNI was evaluated by a multivariate analysis.

Results

The optimal NLR and PNI cutoff values for predicting the 1-year survival after recurrence were 2.2 and 47, respectively. A univariate analysis revealed that the NLR (p < 0.001) and PNI (p < 0.001) were significantly associated with the survival time after recurrence, along with the histology, peritoneal recurrence, carbohydrate antigen 19-9, and chemotherapy for recurrence. In the multivariate analysis, a higher NLR (p < 0.001) and a lower PNI (p = 0.002) were independent predictors of a shorter survival time. Among the patients who underwent chemotherapy, the NLR and PNI were also independent prognostic factors.

Conclusions

Inflammation-based markers, including the NLR and PNI, are simple and useful clinical biomarkers that can be used to predict the survival time of patients with RGC.
Literatur
1.
Zurück zum Zitat Wohrer SS, Raderer M, Hejna M. Palliative chemotherapy for advanced gastric cancer. Ann Oncol. 2004;15:1585–95.CrossRefPubMed Wohrer SS, Raderer M, Hejna M. Palliative chemotherapy for advanced gastric cancer. Ann Oncol. 2004;15:1585–95.CrossRefPubMed
2.
Zurück zum Zitat Wagner AD, Grothe W, Haerting J, Kleber G, Grothey A, Fleig WE. Chemotherapy in advanced gastric cancer: a systematic review and meta-analysis based on aggregate data. J Clin Oncol. 2006;24:2903–9.CrossRefPubMed Wagner AD, Grothe W, Haerting J, Kleber G, Grothey A, Fleig WE. Chemotherapy in advanced gastric cancer: a systematic review and meta-analysis based on aggregate data. J Clin Oncol. 2006;24:2903–9.CrossRefPubMed
3.
Zurück zum Zitat Koizumi W, Narahara H, Hara T, Takagane A, Akiya T, Takagi M, et al. S-1 plus cisplatin versus S-1 alone for first-line treatment of advanced gastric cancer (SPIRITS trial): a phase III trial. Lancet Oncol. 2008;9:215–21.CrossRefPubMed Koizumi W, Narahara H, Hara T, Takagane A, Akiya T, Takagi M, et al. S-1 plus cisplatin versus S-1 alone for first-line treatment of advanced gastric cancer (SPIRITS trial): a phase III trial. Lancet Oncol. 2008;9:215–21.CrossRefPubMed
4.
Zurück zum Zitat Bang YJ, Van Cutsem E, Feyereislova A, Chung HC, Shen L, Sawaki A, et al. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial. Lancet. 2010;376:687–97.CrossRefPubMed Bang YJ, Van Cutsem E, Feyereislova A, Chung HC, Shen L, Sawaki A, et al. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial. Lancet. 2010;376:687–97.CrossRefPubMed
6.
Zurück zum Zitat Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature. 2008;454:436–44.CrossRefPubMed Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature. 2008;454:436–44.CrossRefPubMed
7.
Zurück zum Zitat Walsh SR, Cook EJ, Goulder F, Justin TA, Keeling NJ. Neutrophil–lymphocyte ratio as a prognostic factor in colorectal cancer. J Surg Oncol. 2005;91:181–4.CrossRefPubMed Walsh SR, Cook EJ, Goulder F, Justin TA, Keeling NJ. Neutrophil–lymphocyte ratio as a prognostic factor in colorectal cancer. J Surg Oncol. 2005;91:181–4.CrossRefPubMed
8.
Zurück zum Zitat Proctor MJ, Morrison DS, Talwar D, Balmer SM, Fletcher CD, O’Reilly DS, et al. A comparison of inflammation-based prognostic scores in patients with cancer. A Glasgow inflammation outcome study. Eur J Cancer. 2011;47:2633–41.CrossRefPubMed Proctor MJ, Morrison DS, Talwar D, Balmer SM, Fletcher CD, O’Reilly DS, et al. A comparison of inflammation-based prognostic scores in patients with cancer. A Glasgow inflammation outcome study. Eur J Cancer. 2011;47:2633–41.CrossRefPubMed
9.
Zurück zum Zitat Chua W, Charles KA, Baracos VE, Clarke SJ. Neutrophil/lymphocyte ratio predicts chemotherapy outcomes in patients with advanced colorectal cancer. Br J Cancer. 2011;104:1288–95.CrossRefPubMedPubMedCentral Chua W, Charles KA, Baracos VE, Clarke SJ. Neutrophil/lymphocyte ratio predicts chemotherapy outcomes in patients with advanced colorectal cancer. Br J Cancer. 2011;104:1288–95.CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Shimizu K, Okita R, Saisho S, Yukawa T, Maeda A, Nojima Y, et al. Prognostic nutritional index before adjuvant chemotherapy predicts chemotherapy compliance and survival among patients with non-small-cell lung cancer. Ther Clin Risk Manag. 2015;11:1555–61.CrossRefPubMedPubMedCentral Shimizu K, Okita R, Saisho S, Yukawa T, Maeda A, Nojima Y, et al. Prognostic nutritional index before adjuvant chemotherapy predicts chemotherapy compliance and survival among patients with non-small-cell lung cancer. Ther Clin Risk Manag. 2015;11:1555–61.CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Shimada H, Takiguchi N, Kainuma O, Soda H, Ikeda A, Cho A, et al. High preoperative neutrophil–lymphocyte ratio predicts poor survival in patients with gastric cancer. Gastric Cancer. 2010;13:170–6.CrossRefPubMed Shimada H, Takiguchi N, Kainuma O, Soda H, Ikeda A, Cho A, et al. High preoperative neutrophil–lymphocyte ratio predicts poor survival in patients with gastric cancer. Gastric Cancer. 2010;13:170–6.CrossRefPubMed
12.
Zurück zum Zitat Migita K, Takayama T, Saeki K, Matsumoto S, Wakatsuki K, Enomoto K, et al. The prognostic nutritional index predicts long-term outcomes of gastric cancer patients independent of tumor stage. Ann Surg Oncol. 2013;20:2647–54.CrossRefPubMed Migita K, Takayama T, Saeki K, Matsumoto S, Wakatsuki K, Enomoto K, et al. The prognostic nutritional index predicts long-term outcomes of gastric cancer patients independent of tumor stage. Ann Surg Oncol. 2013;20:2647–54.CrossRefPubMed
13.
Zurück zum Zitat Jeong JH, Lim SM, Yun JY, Rhee GW, Lim JY, Cho JY, et al. Comparison of two inflammation-based prognostic scores in patients with unresectable advanced gastric cancer. Oncology. 2012;83:292–9.CrossRefPubMed Jeong JH, Lim SM, Yun JY, Rhee GW, Lim JY, Cho JY, et al. Comparison of two inflammation-based prognostic scores in patients with unresectable advanced gastric cancer. Oncology. 2012;83:292–9.CrossRefPubMed
14.
Zurück zum Zitat Cho IR, Park JC, Park CH, Jo JH, Lee HJ, Kim S, et al. Pre-treatment neutrophil to lymphocyte ratio as a prognostic marker to predict chemotherapeutic response and survival outcomes in metastatic advanced gastric cancer. Gastric Cancer. 2010;17:703–10.CrossRef Cho IR, Park JC, Park CH, Jo JH, Lee HJ, Kim S, et al. Pre-treatment neutrophil to lymphocyte ratio as a prognostic marker to predict chemotherapeutic response and survival outcomes in metastatic advanced gastric cancer. Gastric Cancer. 2010;17:703–10.CrossRef
15.
Zurück zum Zitat Kong F, Gao F, Chen J, Zheng R, Liu H, Li X, et al. Elevated serum C-reactive protein level predicts a poor prognosis for recurrent gastric cancer. Oncotarget. 2016;7:55765–70.PubMedPubMedCentral Kong F, Gao F, Chen J, Zheng R, Liu H, Li X, et al. Elevated serum C-reactive protein level predicts a poor prognosis for recurrent gastric cancer. Oncotarget. 2016;7:55765–70.PubMedPubMedCentral
16.
Zurück zum Zitat Association Japanese Gastric Cancer. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer. 2011;14:101–12.CrossRef Association Japanese Gastric Cancer. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer. 2011;14:101–12.CrossRef
17.
Zurück zum Zitat Onodera T, Goseki N, Kosaki G. Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients. Nihon Geka Gakkai Zasshi. 1984;85:1001–5.PubMed Onodera T, Goseki N, Kosaki G. Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients. Nihon Geka Gakkai Zasshi. 1984;85:1001–5.PubMed
18.
Zurück zum Zitat Perkins NJ, Schisterman EF. The inconsistency of “optimal” cutpoints obtained using two criteria based on the receiver operating characteristic curve. Am J Epidemiol. 2006;163:670–5.CrossRefPubMedPubMedCentral Perkins NJ, Schisterman EF. The inconsistency of “optimal” cutpoints obtained using two criteria based on the receiver operating characteristic curve. Am J Epidemiol. 2006;163:670–5.CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Sakar B, Karagol H, Gumus M, Basaran M, Kaytan E, Argon A, et al. Timing of death from tumor recurrence after curative gastrectomy for gastric cancer. Am J Clin Oncol. 2004;27:205–9.CrossRefPubMed Sakar B, Karagol H, Gumus M, Basaran M, Kaytan E, Argon A, et al. Timing of death from tumor recurrence after curative gastrectomy for gastric cancer. Am J Clin Oncol. 2004;27:205–9.CrossRefPubMed
20.
Zurück zum Zitat Chiang CY, Huang KH, Fang WL, Wu CW, Chen JH, Lo SS, et al. Factors associated with recurrence within 2 years after curative surgery for gastric adenocarcinoma. World J Surg. 2011;35:2472–8.CrossRefPubMed Chiang CY, Huang KH, Fang WL, Wu CW, Chen JH, Lo SS, et al. Factors associated with recurrence within 2 years after curative surgery for gastric adenocarcinoma. World J Surg. 2011;35:2472–8.CrossRefPubMed
21.
Zurück zum Zitat Bilici A, Salman T, Oven Ustaalioglu BB, Unek T, Seker M, Aliustaoglu M, et al. The prognostic value of detecting symptomatic or asymptomatic recurrence in patients with gastric cancer after a curative gastrectomy. J Surg Res. 2013;180:e1–9.CrossRefPubMed Bilici A, Salman T, Oven Ustaalioglu BB, Unek T, Seker M, Aliustaoglu M, et al. The prognostic value of detecting symptomatic or asymptomatic recurrence in patients with gastric cancer after a curative gastrectomy. J Surg Res. 2013;180:e1–9.CrossRefPubMed
22.
Zurück zum Zitat Otsuji H, Yokoyama Y, Ebata T, Igami T, Sugawara G, Mizuno T, et al. Preoperative sarcopenia negatively impacts postoperative outcomes following major hepatectomy with extrahepatic bile duct resection. World J Surg. 2015;39:1494–500.CrossRefPubMed Otsuji H, Yokoyama Y, Ebata T, Igami T, Sugawara G, Mizuno T, et al. Preoperative sarcopenia negatively impacts postoperative outcomes following major hepatectomy with extrahepatic bile duct resection. World J Surg. 2015;39:1494–500.CrossRefPubMed
23.
Zurück zum Zitat Ikeya T, Shibutani M, Maeda K, Sugano K, Nagahara H, Ohtani H, et al. Maintenance of the nutritional prognostic index predicts survival in patients with unresectable metastatic colorectal cancer. J Cancer Res Clin Oncol. 2015;141:307–13.CrossRefPubMed Ikeya T, Shibutani M, Maeda K, Sugano K, Nagahara H, Ohtani H, et al. Maintenance of the nutritional prognostic index predicts survival in patients with unresectable metastatic colorectal cancer. J Cancer Res Clin Oncol. 2015;141:307–13.CrossRefPubMed
24.
Zurück zum Zitat Rivory LP, Slaviero KA, Clarke SJ. Hepatic cytochrome P450 3A drug metabolism is reduced in cancer patients who have an acute-phase response. Br J Cancer. 2002;87:277–80.CrossRefPubMedPubMedCentral Rivory LP, Slaviero KA, Clarke SJ. Hepatic cytochrome P450 3A drug metabolism is reduced in cancer patients who have an acute-phase response. Br J Cancer. 2002;87:277–80.CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat McMillan DC. Systemic inflammation, nutritional status and survival in patients with cancer. Curr Opin Clin Nutr Metab Care. 2009;12:223–6.CrossRefPubMed McMillan DC. Systemic inflammation, nutritional status and survival in patients with cancer. Curr Opin Clin Nutr Metab Care. 2009;12:223–6.CrossRefPubMed
27.
Zurück zum Zitat Tanaka H, Muguruma K, Toyokawa T, Kubo N, Ohira M, Hirakawa K. Differential impact of the neutrophil–lymphocyte ratio on the survival of patients with stage IV gastric cancer. Dig Surg. 2014;31:327–33.CrossRefPubMed Tanaka H, Muguruma K, Toyokawa T, Kubo N, Ohira M, Hirakawa K. Differential impact of the neutrophil–lymphocyte ratio on the survival of patients with stage IV gastric cancer. Dig Surg. 2014;31:327–33.CrossRefPubMed
Metadaten
Titel
The prognostic significance of inflammation-based markers in patients with recurrent gastric cancer
verfasst von
Kazuhiro Migita
Sohei Matsumoto
Kohei Wakatsuki
Masahiro Ito
Tomohiro Kunishige
Hiroshi Nakade
Mutsuko Kitano
Mitsuhiro Nakatani
Masayuki Sho
Publikationsdatum
23.08.2017
Verlag
Springer Singapore
Erschienen in
Surgery Today
Print ISSN: 0941-1291
Elektronische ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-017-1582-y

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