In Gastric Cancer Patients Receiving Neoadjuvant Chemotherapy Systemic Inflammation Response Index is a Useful Prognostic Indicator

Li Chen; Yong Chen; Lele Zhang; Yingwei Xue; Shiwei Zhang; Xingrui Li; Hongjiang Song

doi:10.3389/pore.2021.1609811

In Gastric Cancer Patients Receiving Neoadjuvant Chemotherapy Systemic Inflammation Response Index is a Useful Prognostic Indicator

Pathol Oncol Res. 2021 Oct 12:27:1609811. doi: 10.3389/pore.2021.1609811. eCollection 2021.

Authors

Li Chen^{1

2}, Yong Chen³, Lele Zhang², Yingwei Xue², Shiwei Zhang⁴, Xingrui Li¹, Hongjiang Song²

Affiliations

¹ Department of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
² Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, China.
³ Department of General Surgery, Huai'an Second People's Hospital and the Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an, China.
⁴ Department of Oncology Surgery, The First People's Hospital of Fuyang Hangzhou, Hangzhou, China.

Abstract

Background: The preoperative systemic inflammation response index (SIRI), based on peripheral neutrophil (N), monocyte (M), and lymphocyte (L) counts, has shown mounting evidence as an effective prognostic indicator in some malignant tumors. The aim of the present study was to evaluate the prognostic significance of pre-treatment SIRI in gastric cancer patients who received neoadjuvant chemotherapy (NACT). Methods: This retrospective study comprised 107 patients with advanced gastric cancer treated with NACT between July 2007 and September 2015 in our hospital. SIRI was calculated from peripheral venous blood samples obtained prior to treatment. The best cutoff value for SIRI by receiver operating characteristic (ROC) curve was 1.2 (low SIRI <1.21, high SIRI ≥1.21). The clinical outcomes of disease-free survival (DFS) and overall survival (OS) were analyzed by Kaplan-Meier survival analysis and compared using the log-rank test. Univariate and multivariate analyses were performed by the Cox proportional hazards regression model. Results: The results demonstrated that the low SIRI group was statistically associated with gender, primary tumor site, white blood cell, neutrophil, and monocyte counts, NLR (neutrophil to lymphocyte ratio), MLR (monocyte to lymphocyte ratio), and PLR (platelet to lymphocyte ratio). The SIRI was predictive for DFS and OS by univariate and multivariate analysis; the low SIRI group had better median DFS and OS than the high SIRI group (median DFS 27.03 vs. 22.33 months, median OS 29.73 vs. 24.43 months). The DFS and OS in the low SIRI group were longer than the high SIRI group. Conclusions: SIRI may qualify as a useful, reliable, and convenient prognostic indicator in patients with advanced gastric cancer to help physicians to provide personalized prognostication for gastric cancer patients treated with NACT.

Keywords: advanced gastric cancer; neoadjuvant chemotherapy; prognosis; systemic inflammation response index (SIRI); tumor indicator.

MeSH terms

Adult
Aged
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
Biomarkers, Tumor / analysis*
Female
Follow-Up Studies
Humans
Inflammation / immunology
Inflammation / pathology*
Lymphocytes / pathology*
Male
Middle Aged
Monocytes / pathology*
Neoadjuvant Therapy / mortality*
Neutrophils / pathology*
Prognosis
ROC Curve
Retrospective Studies
Stomach Neoplasms / drug therapy
Stomach Neoplasms / immunology
Stomach Neoplasms / pathology*
Survival Rate

Substances

Biomarkers, Tumor