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Prognostic Value of Systemic Inflammatory Markers in Predicting Peritoneal Metastasis in Gastric and Gastroesophageal
Mahesh Wadhwa1, Dipali Raju1, Harish Premkumar2
1Department of Surgical Oncology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India.
Abstract:
Gastric cancer and gastroesophageal junction cancer, primarily adenocarcinoma, originate in the stomach's mucosa. Peritoneal metastasis is a common pattern in gastric cancer. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), as systemic inflammation indicators, change before clinical symptoms, aiding early assessment of pathological changes. Without a single diagnostic method for detecting peritoneal metastasis in stomach and gastroesophageal junction cancer, this study examines the predictive value of NLR, PLR, and the albumin-to-derived neutrophil-to-lymphocyte ratio (Alb-dNLR) for peritoneal metastasis. A retrospective observational study was conducted at Kasturba Medical College and Kasturba Hospital, Manipal, in which NLR and PLR were calculated for 168 patients, while Alb-dNLR was determined for 155 patients due to unavailable variables required for calculation. The cutoff values established for albumin, dNLR, NLR, and PLR were 4.22, 2.577833, 1.832388, and 207.1929, respectively. Patients were categorized into high- and low-score groups using the Youden index, and these groups were subsequently compared for the occurrence of peritoneal metastasis. A statistically significant association was identified between the PLR (p-value: 0.004) and the NLR with peritoneal metastasis (p-value: 0.021). Conversely, no statistically significant association was observed between the Alb-dNLR score and peritoneal metastasis (p-value: 0.371). Patients exhibiting elevated preoperative NLR and PLR were at an increased risk of developing peritoneal metastasis. The study identified that elevated preoperative NLR and PLR serve as significant predictors of peritoneal metastasis in gastric cancer and gastroesophageal junction cancer. The study identified that elevated preoperative NLR and PLR were significantly associated with peritoneal metastasis in gastric cancer and gastroesophageal junction cancer.