A Prognostic Nutritional Scoring System Integrating Inflammatory Markers and Body Composition in Gastric Cancer...

Area of Science:

• Oncology
• Surgical Oncology
• Nutritional Science

Background:

• Prognostic value of nutrition and inflammation markers is recognized in cancer.
• Limited research exists on these markers for gastric cancer (GC) patients post-prophylactic intraperitoneal hyperthermic chemotherapy (p-HIPEC).
• Need for a specialized prognostic tool for GC patients undergoing p-HIPEC.

Purpose of the Study:

• To develop and validate a prognostic nutritional scoring system (PNSS).
• To integrate systemic inflammatory markers and body composition parameters for GC patients.
• To enhance survival prediction in GC patients treated with p-HIPEC.

Main Methods:

• Computed tomography for body composition assessment.
• Preoperative recording of systemic inflammatory markers.
• Development of PNSS using platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), lymphocyte-to-monocyte ratio (LMR), skeletal muscle index (SMI), and sarcopenia-myosteatosis risk (SMR) score.
• Validation against the TNM model for overall survival (OS) prediction.

Main Results:

• Incidences of sarcopenia, myosteatosis, and sarcopenic obesity were 32.6%, 27.3%, and 18.7% respectively in 267 GC patients.
• PLR identified as a significant risk factor for sarcopenia and myosteatosis.
• PNSS showed superior predictive accuracy for OS compared to the TNM model (e.g., 3-year OS: C-index 0.76 vs. 0.71).

Conclusions:

• The PNSS effectively integrates body composition and inflammatory markers.
• PNSS offers robust prognostic value for predicting OS in GC patients.
• This scoring system is beneficial for GC patients undergoing curative resection with p-HIPEC.