Comparison of the prognostic value of tumour and patient related factors in patients undergoing potentially curative resection of gastric cancer

Am J Surg. 2012 Sep;204(3):294-9. doi: 10.1016/j.amjsurg.2011.10.015. Epub 2012 Mar 22.

Abstract

Background: There is increasing evidence that the patient-related systemic inflammatory response is a powerful prognostic factor. The aim of the present study was to compare the prognostic value of selected markers of the systemic inflammatory response in patients undergoing resection of gastric cancer.

Methods: One hundred twenty patients undergoing resection of gastric cancer, had measurements of various systemic inflammatory markers in addition to tumor-related factors. From these, the modified Glasgow Prognostic Score (mGPS), neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and metastatic lymph node ratio were calculated.

Results: On multivariate analysis, only the ratio of positive to total lymph nodes (hazard ratio, 2.29%; 95% confidence interval, 1.57%-3.33%; P < .001) and the mGPS (hazard ratio, 2.23%; 95% confidence interval, 1.40%-3.54%; P = .001) were independently associated with cancer-specific survival in patients with gastric cancer. An increase in the mGPS was associated with a higher neutrophil/lymphocyte ratio (P < .05) and poorer survival (P < .001).

Conclusions: The present study indicates that the mGPS, an acute-phase, protein-based prognostic score, is a superior predictor of cancer survival compared with the cellular components of the systemic inflammatory response in patients undergoing resection of gastric cancer.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Biomarkers, Tumor / blood*
  • Blood Platelets / pathology
  • C-Reactive Protein / metabolism*
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Leukocyte Count
  • Lymph Nodes / pathology*
  • Lymphatic Metastasis
  • Lymphocytes / pathology
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Staging
  • Neutrophils / pathology
  • Odds Ratio
  • Predictive Value of Tests
  • Prognosis
  • Serum Albumin / metabolism*
  • Stomach Neoplasms / blood*
  • Stomach Neoplasms / mortality
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery*

Substances

  • Biomarkers, Tumor
  • Serum Albumin
  • C-Reactive Protein