The effect of pre-treatment inflammatory response markers on survival in locally advanced unresectable and metastatic gastric cancer: a retrospective cross-sectional study

Abstract

Purpose: We evaluated the effect of pre-treatment inflammation response markers on overall survival (OS) and progression-free survival (PFS) in patients with locally advanced unresectable and metastatic gastric cancer. Material and method: Patients with locally advanced unresectable and metastatic gastric cancer between January 2016 and December 2021 were included. Among these patients, 114 patients with ECOG (Eastern Cooperative Oncology Group) Performance status 0-2, who received at least one line of chemotherapy, had no comorbidities and brain metastases were included in the study. Pre-treatment platelet, lymphocyte, leukocyte, neutrophil, monocyte, albumin, C-reactive protein (CRP), lactatedehydrogenase (LDH) levels, histology types, age, surgical history, treatment history and ECOG Performance status were retrospectively analysed from their records. Threshold values were determined by ROC analysis. Kaplan-Meier survival analyses were used for survival analyses. Hazard ratio (HR) and confidence intervals (CI) of the factors affecting overall survival (OS) and progression-free survival (PFS) were calculated using Coxproportional-hazards model. Results: The median age of the patients was 63.5±11.9 (28-80). Among the patients, 69 (60.5%) were in metastatic stage. 106 (93.0%) patients had poorly differentiated carcinoma histology. Progression developed in 88.6% (101) of patients and 98 patients (86%) were deceased. In the whole group, mPFS was 9.4±0.9 (95%CI 7.7-11.0) months and mOS was 14.1±1.6 (95%CI 10.8-17.2) months. When the Coxproportional-hazards model was used, the factors affecting OS were advanced age, metastatic stage, neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), derived neutrophil lymphocyte ratio (dNLR) and lactate dehydrogenase (LDH), while the factors affecting PFS were advanced age, metastatic stage, NLR, dNLR and LDH. Conclusion: While NLR, PLR, dNLR, dNLR and LDH affect OS, LDH affects PFS. Systemic inflammatory markers of locally advanced unresectable and metastatic gastric cancers before chemotherapy can be used to predict prognosis. © 2023, Pamukkale University. All rights reserved.