Yetmiş Beş Yaş Üstü Metastatik Mide Kanserli Hastalarda Hemoglobin, Albümin, Lenfosit, Platelet (HALP) Skoru ile Geriatrik Nütrisyonel İndeks (GNRI) ve Prognoz Arasındaki İlişki

Amaç: Mide kanseri (MK) sık görülen ve mortalitesi yüksek bir kanserdir. Evre, prognozun en önemli belirleyicisidir. Ancak aynı evrede olan hastaların klinik seyri farklı olabilir. Bu nedenle evre dışında başka prognostik belirteçlere ihtiyaç vardır. Hemoglobin, albümin, lenfosit ve trombosit (HALP) skoru ve geriatrik nütrisyonel risk indeksi (GNRI) birçok malignitede prognoz ile ilişkilidir, ancak ileri yaştaki mide kanserli hastalarda prognozla ilişkisi bilinmemektedir. Bu nedenle metastatik, 75 yaş üstü, kemoterapi alan mide kanserli hastaları retrospektif olarak inceledik. Gereç ve Yöntemler: İkinci basamak bir devlet hastanesinde 2009-2022 yılları arasında kemoterapi alan, 75 yaş üstü metastatik mide kanserli 145 hasta retrospektif olarak incelendi. Hastaların cinsiyeti, yaşı, Eastern Cooperative Oncology Group (ECOG) performans skoru, tanı tarihleri, kontrole geliş tarihleri, albümin seviyeleri, hemoglobin, laktat dehidrogenaz (LDH), beyaz küre sayısı, nötrofil, lenfosit ve trombosit sayısı, ağırlık (kg), boy (cm) değerleri incelendi. Bu değerler kullanarak HALP skoru, GNRI, genel sağkalım (OS) hesaplandı. ardından bu parametrelerin OS ile ilişkisi retrospektif olarak analiz edildi. Bulgular: Medyan genel sağkalım (OS) 8.1 (%95 Güven aralığı (GA), 7.07 – 9.13) aydı. Çok değişkenli analizde, GNRI (0.035) ve HALP skoru (p<0.001) sağkalım süresi ile ilişkiliydi. Medyan OS, düşük HALP grubunda 4,5 (%95 C,3.77-5.24 ) ay ve yüksek HALP grubunda 10.2 (%95 CI, 9.04- 11.36 ) ay saptandı (p<0.001). Medyan OS, düşük GNRI grubunda 6.2 (%95 GA, 4.25-8.14) ay ve yüksek GNRI grubunda 8.6 (%95 GA, 7.92-9.27) ay saptandı. Sonuç: GNRI ve HALP skoru, 75 yaş üstü metastatik, mide kanserli hastalarda sağkalım süresi ile ilişkilidir. Metastatik mide kanserli yaşlı hastalarda takip stratejisi geliştirmek, tedavi planlamak ve prognoz belirlemek için kolay, ucuz ve pratik bir yöntem olarak kullanılabilir

Anahtar Kelimeler:

GNRI, Yaşlı mide kanseri, HALP skoru, GNRI, Geriatrik nutrisyonel risk indeksi, prognoz

Relationship Between Hemoglobin, Albumin, Lymphocyte and Platelet (HALP) Score and Geriatric Nutritional Risk Index (GNRI) and Prognosis in Patients Over 75 Years of Age with Metastatic Gastric Cancer

Aim: Gastric cancer (GC) is a common cancer with high mortality. Stage is the most important predictor of prognosis. But the clinical course of patients who are at the same stage may be different. Therefore, other prognostic markers other than stage are needed. Hemoglobin, albumin, lymphocyte and platelet (HALP) score and geriatric nutritional risk index (GNRI) related with prognosis in many malignancies, but their relationship to prognosis in patients with GC with advanced age is unknown. For this reason, we retrospectively analyzed patients older than 75 years, receiving chemotherapy, and metastatic GC. Material and Methods: We retrospectively analyzed 145 patients with metastatic gastric cancer, older than 75 years, receiving chemotherapy in secondary level state hospital between 2009 and 2022. Patients’ gender, age, Eastern Cooperative Oncology Group (ECOG) performance score, diagnosis dates, follow-up visits, albumin, hemoglobin, lactate dehydrogenase (LDH) levels, white blood cell, neutrophil, lymphocyte and platelet count, weight (kg), height (cm) values were examined. Using these values, HALP score, GNRI, and overall survival (OS) were calculated. Then, the relationship of these parameters with OS was analyzed retrospectively. Results: The median overall survival (OS) was 8.1 (95% Confidence interval (CI), 7.07 – 9.13) months. In multivariate analysis, GNRI (0.035) and HALP (p<0.001) were associated with survival time. Median OS was 4.5 (95% C,3.77-5.24 ) months in the low HALP group, and 10.2 (95% CI, 9.04- 11.36 ) months in the high HALP group (p<0.001). Median OS was 6.2 (95% CI, 4.25-8.14) months in the low GNRI group and 8.6 (95% CI, 7.92-9.27) months in the high GNRI group. Conclusion: GNRI and HALP score are associated with survival in metastatic GC patients older than 75 years. GNRI and HALP score can be used as an easy, cheap and practical method for follow-up, treatment and prognosis in elderly patients with metastatic GC.

Keywords:

Elderly gastric cancer, HALP score, GNRI, Geriatric nutritional risk index, prognosis,

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