Combining systemic inflammatory response index and albumin fibrinogen ratio to predict early serious complications and prognosis after resectable gastric cancer

Jing-Yao Ren; Da Wang; Li-Hui Zhu; Shuo Liu; Miao Yu; Hui Cai

doi:10.4251/wjgo.v16.i3.732

Combining systemic inflammatory response index and albumin fibrinogen ratio to predict early serious complications and prognosis after resectable gastric cancer

World J Gastrointest Oncol. 2024 Mar 15;16(3):732-749. doi: 10.4251/wjgo.v16.i3.732.

Authors

Jing-Yao Ren^{1

2

3

4}, Da Wang^{2

3

4

5}, Li-Hui Zhu^{1

2

3

4}, Shuo Liu^{2

3

4

6}, Miao Yu^{2

3

4}, Hui Cai^{1

2

3

4

7}

Affiliations

¹ School of Clinical Medicine, Ningxia Medical University, Yinchuan 750000, Ningxia Hui Autonomous Region, China.
² General Surgery Clinical Medical Center, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China.
³ Key Laboratory of Molecular Diagnostics and Precision Medicine for Surgical Oncology in Gansu Province, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China.
⁴ NHC Key Laboratory of Diagnosis and Therapy of Gastrointestinal Tumor, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China.
⁵ Medical College of Jiangsu University, Jiangsu University, Zhenjiang 212013, Jiangsu Province, China.
⁶ The First Clinical Medical School, Lanzhou University, Lanzhou 730000, Gansu Province, China.
⁷ The First Clinical Medical School, Lanzhou University, Lanzhou 730000, Gansu Province, China. caialonteam@163.com.

Abstract

Background: Gastric cancer has a high incidence and fatality rate, and surgery is the preferred course of treatment. Nonetheless, patient survival rates are still low, and the incidence of major postoperative complications cannot be disregarded. The systemic inflammatory response, nutritional level, and coagulation status are key factors affecting the postoperative recovery and prognosis of gastric cancer patients. The systemic inflammatory response index (SIRI) and the albumin fibrinogen ratio (AFR) are two valuable comprehensive indicators of the severity and prognosis of systemic inflammation in various medical conditions.

Aim: To assess the clinical importance and prognostic significance of the SIRI scores and the AFR on early postoperative outcomes in patients undergoing radical gastric cancer surgery.

Methods: We conducted a retrospective analysis of the clinicopathological characteristics and relevant laboratory indices of 568 gastric cancer patients from January 2018 to December 2019. We calculated and compared two indicators of inflammation and then examined the diagnostic ability of combined SIRI and AFR values for serious early postoperative complications. We scored the patients and categorized them into three groups based on their SIRI and AFR levels. COX analysis was used to compare the three groups of patients the prognostic value of various preoperative SIRI-AFR scores for 5-year overall survival (OS) and disease-free survival (DFS).

Results: SIRI-AFR scores were an independent risk factor for prognosis [OS: P = 0.004; hazards ratio (HR) = 3.134; DFS: P < 0.001; HR = 3.543] and had the highest diagnostic power (area under the curve: 0.779; 95% confidence interval: 0.737-0.820) for early serious complications in patients with gastric cancer. The tumor-node-metastasis stage (P = 0.001), perioperative transfusion (P = 0.044), positive carcinoembryonic antigen (P = 0.014) findings, and major postoperative complications (P = 0.011) were factors associated with prognosis.

Conclusion: Preoperative SIRI and AFR values were significantly associated with early postoperative survival and the occurrence of severe complications in gastric cancer patients.

Keywords: Albumin fibrinogen ratio; Complications; Gastric cancer; Inflammation; Prognosis.