2a74ecb5af36ad1e2d451b5399dbf0fd cancers-16-02188.pdf 40584d1ad94cb0fe507df875b5c5b8828ada0eb7 cancers-16-02188.pdf f93603a438d0b7b1709e7fa2d2ca3344fbbbaebeb9ad0a7a8a29e66ec9e7c7d8 cancers-16-02188.pdf Title: Prognostic Relevance of Preoperative Immune, Inflammatory, and Nutritional Biomarkers in Patients Undergoing Gastrectomy for Resectable Gastric Adenocarcinoma: An Observational Multicentre Study Subject: Background: The aim of this study was to evaluate different preoperative immune, inflammatory, and nutritional scores and their best cut-off values as predictors of poorer overall survival (OS) and disease-free survival (DFS) in patients who underwent curative gastric cancer resection. Methods: This was a retrospective observational multicentre study based on data of the Spanish EURECCA Esophagogastric Cancer Registry. Time-dependent Youden index and log-rank test were used to obtain the best cut-offs of 18 preoperative biomarkers for OS and DFS. An adjusted Cox model with variables selected by bootstrapping was used to identify the best preoperative biomarkers, which were also analysed for every TNM stage. Results: High neutrophil-to-lymphocyte ratio (NLR), high monocyte systemic inflammation index (moSII), and low prognostic nutritional index (PNI) were identified as independent predictors of poor outcome: NLR > 5.91 (HR:1.73; 95%CI [1.23–2.43]), moSII >2027.12 (HR:2.26; 95%CI [1.36–3.78]), and PNI >40.31 (HR:0.75; 95%CI [0.58–0.96]) for 5-year OS and NLR > 6.81 (HR:1.75; 95%CI [1.24–2.45]), moSII > 2027.12 (HR:2.46; 95%CI [1.49–4.04]), and PNI > 40.31 (HR:0.77; 95%CI [0.60,0.97]) for 5-year DFS. These outcomes were maintained in the whole cohort for NLR and moSII (p < 0.05) but not in stage II and for PNI in all tumoral stages. The associations of NLR-PNI and moSII-PNI were also a relevant prognostic factor for OS. Conclusions: High NLR, high moSII (for stages I and III), and low PNI (regardless of tumour stage) were the most promising preoperative biomarkers to predict poor OS and DFS in gastric cancer patients treated with curative intent. Keywords: gastric cancer; preoperative biomarker; preoperative inflammation score; preoperative immune score; preoperative nutritional score Author: Jaume Tur-Martínez, Joaquín Rodríguez-Santiago, Javier Osorio, Mònica Miró, Concepción Yarnoz, Mariona Jofra, Georgina Ferret, Helena Salvador-Roses, Sonia Fernández-Ananín, Arantxa Clavell, Alexis Luna, Aurora Aldeano, Carles Olona, Judith Hermoso, Mercè Güell-Farré, Mariagiulia Dal Cero, Marta Gimeno, Natàlia Pallarès and Manuel Pera Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Tue Jun 11 10:06:52 2024 CEST ModDate: Tue Jun 11 10:09:15 2024 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 17 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 920756 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- ILBFIC+VnURWPalladioL-Bold Type 1 Custom yes yes yes 10 0 LTASEI+URWPalladioL-Bold Type 1 Custom yes yes yes 16 0 KXCVNE+URWPalladioL-Roma Type 1 Custom yes yes yes 22 0 SYNWBI+URWPalladioL-Ital Type 1 Custom yes yes yes 27 0 SXQPWE+VnURWPalladioL Type 1 Custom yes yes yes 32 0 LCJEVJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 49 0 VBAQIR+CMSY10 Type 1 Builtin yes yes yes 69 0 QLBIEB+URWPalladioL-BoldItal Type 1 Custom yes yes yes 80 0 ABHGMM+Arial CID TrueType Identity-H yes yes yes 104 0 ABHEDC+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 110 0 ABHEDE+PalatinoLinotype TrueType WinAnsi yes yes no 113 0 ABHEDG+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 116 0 ABHENE+PalatinoLinotype TrueType MacRoman yes yes no 119 0 SCVSBO+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 150 0 ABHEDG+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 158 0 ABHEDC+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 161 0 ABHEDE+PalatinoLinotype TrueType WinAnsi yes yes no 164 0 OGJDJR+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 178 0 ABHEDG+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 186 0 ABHEDC+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 189 0 ABHEDE+PalatinoLinotype TrueType WinAnsi yes yes no 192 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-07-19 02:43:02 CEST RepresentationInformation: cancers-16-02188.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-07-18 12:44:44 CEST Size: 920756 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 380 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Methods Destination: section.2 Children: Item: Title: Source of Data Destination: subsection.2.1 Item: Title: Ethics Destination: subsection.2.2 Item: Title: Patients Destination: subsection.2.3 Item: Title: Data Collection Destination: subsection.2.4 Item: Title: Statistical Analysis Destination: subsection.2.5 Item: Title: Results Destination: section.3 Children: Item: Title: Descriptive Analysis Destination: subsection.3.1 Item: Title: Excluded Preoperative Biomarkers Destination: subsection.3.2 Item: Title: Most Relevant Preoperative Biomarkers Destination: subsection.3.3 Item: Title: Tumour Stage and Preoperative Biomarkers Destination: subsection.3.4 Item: Title: Combination of Preoperative Biomarkers Destination: subsection.3.5 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: appendix.A. Info: Title: Prognostic Relevance of Preoperative Immune, Inflammatory, and Nutritional Biomarkers in Patients Undergoing Gastrectomy for Resectable Gastric Adenocarcinoma: An Observational Multicentre Study Author: Jaume Tur-Martínez, Joaquín Rodríguez-Santiago, Javier Osorio, Mònica Miró, Concepción Yarnoz, Mariona Jofra, Georgina Ferret, Helena Salvador-Roses, Sonia Fernández-Ananín, Arantxa Clavell, Alexis Luna, Aurora Aldeano, Carles Olona, Judith Hermoso, Mercè Güell-Farré, Mariagiulia Dal Cero, Marta Gimeno, Natàlia Pallarès and Manuel Pera Subject: Background: The aim of this study was to evaluate different preoperative immune, inflammatory, and nutritional scores and their best cut-off values as predictors of poorer overall survival (OS) and disease-free survival (DFS) in patients who underwent curative gastric cancer resection. Methods: This was a retrospective observational multicentre study based on data of the Spanish EURECCA Esophagogastric Cancer Registry. Time-dependent Youden index and log-rank test were used to obtain the best cut-offs of 18 preoperative biomarkers for OS and DFS. An adjusted Cox model with variables selected by bootstrapping was used to identify the best preoperative biomarkers, which were also analysed for every TNM stage. Results: High neutrophil-to-lymphocyte ratio (NLR), high monocyte systemic inflammation index (moSII), and low prognostic nutritional index (PNI) were identified as independent predictors of poor outcome: NLR > 5.91 (HR:1.73; 95%CI [1.23 2.43]), moSII >2027.12 (HR:2.26; 95%CI [1.36 3.78]), and PNI >40.31 (HR:0.75; 95%CI [0.58 0.96]) for 5-year OS and NLR > 6.81 (HR:1.75; 95%CI [1.24 2.45]), moSII > 2027.12 (HR:2.46; 95%CI [1.49 4.04]), and PNI > 40.31 (HR:0.77; 95%CI [0.60,0.97]) for 5-year DFS. These outcomes were maintained in the whole cohort for NLR and moSII (p < 0.05) but not in stage II and for PNI in all tumoral stages. The associations of NLR-PNI and moSII-PNI were also a relevant prognostic factor for OS. Conclusions: High NLR, high moSII (for stages I and III), and low PNI (regardless of tumour stage) were the most promising preoperative biomarkers to predict poor OS and DFS in gastric cancer patients treated with curative intent. 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