학술논문
The effect of pre-treatment inflammatory response markers on survival in locally advanced unresectable and metastatic gastric cancer: a retrospective cross-sectional study/Lokal ileri rezeke edilemeyen ve metastatik mide kanserinde tedavi oncesi inflamasyon yaniti belirteclerinin sagkalim uzerine etkisi
Document Type
Academic Journal
Author
Source
Pamukkale Medical Journal. July, 2023, Vol. 16 Issue 3, p434, 12 p.
Subject
Language
English
ISSN
1309-9833
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[+ or -]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[+ or -]0.9 (95%CI 7.7-11.0) months and mOS was 14.1[+ or -]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. Key words: Gastric cancer, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, prognosis. Dogan T, Yaren A, Demiray AG, Yapar Taskoylu B, Cakan Demirel B, Ozdemir M, Guclu Kantar T, Degirmencioglu S, Gokoz Dogu G. The effect of pre-treatment inflammatory response markers on survival in locally advanced unresectable and metastatic gastric cancer: a retrospective cross-sectional study. Pam Med J 2023;16:434-445. Amac: Lokal ileri rezeke edilemeyen ve metastatik mide kanserli hastalarda tedavi oncesi inflamasyon yaniti belirteclerinin tum sagkalim (TSK) ve progresyonsuz sagkalim (PSK) uzerine etkisini degerlendirildi. Gerec ve yontem: Ocak 2016-Aralik 2021 tarihleri arasinda lokal ileri rezeke edilemeyen ve metastatik mide kanserli hastalar alindi. Bu hastalardan en az bir sira kemoterapi almis ECOG (Eastern Cooperative Oncology Group) Performans durumu 0-2 olan, komorbiditesi ve beyin metastazi olmayan 114 hasta calismaya dahil edildi. Tedavi oncesi platelet, lenfosit, lokosit, notrofil, monosit, albumin, C-reaktif protein (CRP), laktatdehidrogenaz (LDH) duzeyleri, histoloji tipleri, yasi, cerrahi oykusu, tedavi oykusu ve ECOG Performans durumu dosyalarindan retrospektif olarak incelendi. Tum degerlerin esik degeri ROC analizi ile belirlendi. Sagkalim analizleri icin Kaplan-Meier Sagkalim analizleri kullanildi. Coxproportional-hazards modeli kullanilarak tum sagkalim (TSK) ve progresyonsuz sagkalim (PSK)'i etkileyen faktorlerin hazardratio (HR) ve guven araliklari (CI) hesaplandi. Bulgular: Hastalarin ortanca yasi 63,5[+ or -]11,9 (28-80) yil. Hastalarin 69 (%60,5)'u metastatik evredeydi. Yuzalti (%93,0) hastanin histolojisi az differasiye karsinomdu. Hastalarin %88,6'sinda (101) progresyon gelisti ve 98 hasta (%86) vefat etti. Tum grupta mPSK 9,4+0,9 (%95CI 7,7-11,0) ay ve mOS 14,1+1,6 (%95CI 10,8-17,2) ay saptandi. Coxproportional-hazards modeli kullanildiginda TSK'i etkileyen faktorler ileri yas, metastatik evre, notrofil lenfosit orani (NLO), platelet lenfosit orani (PLO), derive notrofil lenfosit orani (dNLO) ve laktak dehidrogenaz (LDH) iken; PSK'yi etkileyen faktorler ileri yas, metastatik evre, NLO, dNLO ve LDH olarak bulundu. Sonuc: Tedavi oncesi inflamasyon yaniti belirteclerinden NLO, PLO, dNLO ve LDH OS'yi etkilerken; LDH PSK'yi etkilemektedir. Lokal ileri rezeke edilemeyen ve metastatik evre mide kanserlerinin kemoterapi oncesi sistemik inflamatuvar belirtecleri prognozu ongormede kullanilabilir. Anahtar kelimeler: Mide kanseri, notrofil-lenfosit orani, platelet-lenfosit orani, prognoz. Dogan T, Yaren A, Demiray AG, Yapar Taskoylu B, Cakan Demirel B, Ozdemir M, Guclu Kantar T, Degirmencioglu S, Gokoz Dogu G. Lokal ileri rezeke edilemeyen ve metastatik mide kanserinde tedavi oncesi inflamasyon yaniti belirteclerinin sagkalim uzerine etkisi. Pam Tip Derg 2023;16:434-445.
Introduction Gastric cancer is the 5th most common cancer. It is the 4th most common cause of death [1]. Generally, being asymptomatic in the early stages of the disease, the [...]
Introduction Gastric cancer is the 5th most common cancer. It is the 4th most common cause of death [1]. Generally, being asymptomatic in the early stages of the disease, the [...]