Salih Burak GÜNDOĞDU, Gökhan AKKURT, Merve AKIN, Tezcan AKIN, Sadettin ER, Birkan BİRBEN, Deniz TİKİCİ, Mesut TEZ, Hüseyin BERKEM

Mide kanserinin küratif rezeksiyonundan sonra sağkalımı ön görmede new prognostic western score’ un eksternal validasyonu

Amaç: Gastrik kanserlerde prognoz etki eden faktörlere bağlı olarak farklı seyredebilmektedir. Biz çalışmamızda küratif rezeksiyon yapılan gastrik kanserlerin sağkalımını ön görmede kullanılan new prognostic western score’ un eksternal validasyonunu değerlendirdik. Gereç ve Yöntemler: Hastanemizde 2004- 2015 yılları arasında gastrik adeno kanser nedeniyle küratif rezeksiyon yapılan 18 yaş üzeri 139 hasta çalışmaya dahil edildi. Hastaların demografik özellikleri albümin, nötrofil lenfosit oranı ve patolojik tümör-lenf nodu-metastaz evresi değerlendirildi. Bulgular: Hastaların 59 (%42,4)’ u kadın, 80 (%57,6)’ i erkekti. Albümin ortalama değeri 39±7 mg/L, nötrofil lenfosit oranı medyan değeri 2,5 (1,76-4) idi. Hastaların patolojik tümör-lenf nodu-metastaz evrelemesine göre 13 (%9,4)’ ü evre 1, 21 (%15,1)’ i evre 2, 99 (%71,2)’u evre 3, ve 6 (%4,3)’ sı evre 4 teydi. Hastaların 5 yıllık medyan sağkalımı 32,5 ay idi. Yaş mortalite grubunda anlamlı yüksek bulundu (P= 0,021). Log rank analizinde mortalite grubunda albümin düşüklüğü, nötrofil lenfosit oranı yüksekliği ve tümör-lenf nodu-metastaz evresi yüksekliği istatistiksel anlamlıydı (P= 0,001, 0,000 ve 0,030 sırasıyla). Cox regresyon analizinde anlamlı değişken sadece patolojik evre olarak belirlendi ( P=0,005). Sonuç: Mide kanserlerinde new prognostic western score prognozu göstermede anlamlı bulunmadı.

Anahtar Kelimeler:

albümin, nötrofil lenfosit oranı, sağkalım, mide kanseri

External validation of the new prognostic western score in predicting survival after curative resection of gastric cancer

Aim: Gastric cancers may progress differently depending on the factors affecting the prognosis. In our study, we evaluated the external validation of the new prognostic western score used to predict the surveillance of gastric cancer patients undergoing curative resection. Material and methods: The study included 139 patients over 18 years of age who underwent curative resection for gastric adenocarcinoma in our hospital between 2004 and 2015. The demographic characteristics of the patients and their albumin level, neutrophil lymphocyte ratio and pathological tumor-nodes-metastasis stage were evaluated. Results: Fifty-nine (42.4%) of the patients were female and 80 (57.6%) were male. The mean albumin value was 39±7 mg/L, and the median value of the neutrophil/lymphocyte ratio was 2.5 (1.76-4). According to the pathological tumor-nodes-metastasis staging, 13 cases (9.4%) were stage 1, 21 (15.1%) stage 2, 99 (71.2%) stage 3, and 6 (4.3%) stage 4. The five-year median survival of the patients was 32.5 months. Age was significantly higher in the mortality group (P=.021). In the log-rank analysis, a low albumin level, a high neutrophil lymphocyte ratio, and a high tumor-nodes-metastasis stage were statistically significant in the mortality group (P=.001, .000 and .030 respectively). In the Cox regression analysis, the only significant variable was determined as pathological stage (P=.005). Conclusion: The new prognostic western score was not significant in predicting the prognosis of gastric cancers.

Keywords:

albumin, neutrophil/lymphocyte ratio, survival, gastric cancer,

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1.Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer j Clin. 2018; 68: 394-424.
2.Digklia A, Wagner AD. Advanced gastric cancer: current treatment landscape and future perspectives. World J Gastroenterol. 2016; 22: 2403.
3.Amin MB, Edge SB. AJCC cancer staging manual. springer; 2017.
4.Shao Y, Geng Y, Gu W, et al. Assessment of lymph node ratio to replace the pN categories system of classification of the TNM system in esophageal squamous cell carcinoma. J Thorac Oncol. 2016; 11: 1774-84.
5.Cools-Lartigue J, Spicer J, McDonald B, et al. Neutrophil extracellular traps sequester circulating tumor cells and promote metastasis. J Clin Invest. 2013; 123: 3446-58.
6.Luigina G, Elisabetta M, Cristina VM, Annibale D. New prognostic western score predicting survival after curative resection of gastric cancer. Updates Surg. 2020: 1-8.
7.Sun X, Liu X, Liu J et al. Preoperative neutrophil-to-lymphocyte ratio plus platelet-to-lymphocyte ratio in predicting survival for patients with stage I–II gastric cancer. Chin J Cancer. 2016; 35: 57.
8.Graziosi L, Marino E, De Angelis V, Rebonato A, Cavazzoni E, Donini A. Prognostic value of preoperative neutrophils to lymphocytes ratio in patients resected for gastric cancer. Am J Surg. 2015; 209: 333-37.
9.Liu X, Sun X, Liu J et al. Preoperative C-reactive protein/albumin ratio predicts prognosis of patients after curative resection for gastric cancer. Transl Oncol. 2015; 8: 339-45.
10.Shen Q, Liu W, Quan H et al. Prealbumin and lymphocyte-based prognostic score, a new tool for predicting long-term survival after curative resection of stage II/III gastric cancer. Br J Nutr. 2018; 120: 1359-69.
11.Lu J, Dai Y, Xie J-W et al. Combination of lymphovascular invasion and the AJCC TNM staging system improves prediction of prognosis in N0 stage gastric cancer: results from a high-volume institution. BMC cancer. 2019; 19: 1-9.