Clinical Impact of the Prognostic Nutritional Index as a Predictor of Outcomes in Patients with Stage II/III Gastric Cancer: A Retrospective Cohort Study.
Aged
Aged, 80 and over
Chemotherapy, Adjuvant
Docetaxel
/ therapeutic use
Drug Combinations
Female
Gastrectomy
/ methods
Humans
Male
Middle Aged
Neoplasm Recurrence, Local
/ blood
Neoplasm Staging
Nutrition Assessment
Oxonic Acid
/ therapeutic use
Practice Guidelines as Topic
Prognosis
Retrospective Studies
Stomach Neoplasms
/ blood
Survival Analysis
Tegafur
/ therapeutic use
Treatment Outcome
Adjuvant chemotherapy
Disease recurrence
Gastric cancer
Prognostic nutritional index
Journal
Oncology
ISSN: 1423-0232
Titre abrégé: Oncology
Pays: Switzerland
ID NLM: 0135054
Informations de publication
Date de publication:
2021
2021
Historique:
received:
21
12
2020
accepted:
19
01
2021
pubmed:
8
3
2021
medline:
3
6
2021
entrez:
7
3
2021
Statut:
ppublish
Résumé
The Japanese Gastric Cancer Treatment Guidelines recommend S-1 and S-1 plus docetaxel as postoperative chemotherapy for pathological stage II and III gastric cancer (GC). There is currently no strategy for using chemotherapy to treat high-risk recurrent pathological stage II/III. Previous studies reported that the several nutritional, immunological, and inflammatory markers examined the association with clinical outcomes after surgery for GC. Ninety patients with GC (stage II, n = 48; stage III, n = 42) for whom gastrectomy was performed at our institution between November 2009 and September 2018 were examined. Nutritional, immunological, and inflammatory markers were calculated from blood samples within 1 week before surgery. The prognostic nutritional index (PNI) status correlated with the pathological stage and disease recurrence after surgery (p = 0.015 and p < 0.0001, respectively). Thirty-three patients had disease recurrence after gastrectomy (stage II, n = 11; stage III, n = 22). The PNI was significantly lower in the recurrent group than in the non-recurrent group (p = 0.0003). The PNI correlated with overall survival and recurrence-free survival after gastrectomy (p = 0.0021 and p = 0.0001, respectively). A multivariate analysis identified the PNI as an independent prognostic factor (p = 0.006). The PNI may be useful for predicting the outcomes of patients with pathological stage II/III GC and may contribute to the selection of an appropriate adjuvant chemotherapy regimen.
Sections du résumé
BACKGROUND
BACKGROUND
The Japanese Gastric Cancer Treatment Guidelines recommend S-1 and S-1 plus docetaxel as postoperative chemotherapy for pathological stage II and III gastric cancer (GC). There is currently no strategy for using chemotherapy to treat high-risk recurrent pathological stage II/III. Previous studies reported that the several nutritional, immunological, and inflammatory markers examined the association with clinical outcomes after surgery for GC.
METHODS
METHODS
Ninety patients with GC (stage II, n = 48; stage III, n = 42) for whom gastrectomy was performed at our institution between November 2009 and September 2018 were examined. Nutritional, immunological, and inflammatory markers were calculated from blood samples within 1 week before surgery.
RESULTS
RESULTS
The prognostic nutritional index (PNI) status correlated with the pathological stage and disease recurrence after surgery (p = 0.015 and p < 0.0001, respectively). Thirty-three patients had disease recurrence after gastrectomy (stage II, n = 11; stage III, n = 22). The PNI was significantly lower in the recurrent group than in the non-recurrent group (p = 0.0003). The PNI correlated with overall survival and recurrence-free survival after gastrectomy (p = 0.0021 and p = 0.0001, respectively). A multivariate analysis identified the PNI as an independent prognostic factor (p = 0.006).
CONCLUSION
CONCLUSIONS
The PNI may be useful for predicting the outcomes of patients with pathological stage II/III GC and may contribute to the selection of an appropriate adjuvant chemotherapy regimen.
Identifiants
pubmed: 33677434
pii: 000514572
doi: 10.1159/000514572
doi:
Substances chimiques
Drug Combinations
0
S 1 (combination)
150863-82-4
Tegafur
1548R74NSZ
Docetaxel
15H5577CQD
Oxonic Acid
5VT6420TIG
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
380-388Informations de copyright
© 2021 S. Karger AG, Basel.