Ciência e terapia do câncer

The Role of Baseline Inflammatory Response Biomarkers in Predictingthe Prognosis in Non Metastatic Gastric Cancer Patients Treated with Preoperative Chemoradiation

Abstract

Hala Zaghloul and Ahmed Abbas

Purpose: To delve into the prospective of inflammatory-related indicators as neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), derived neutrophil to lymphocyte ratio (dNLR), and lymphocyte to monocyte ratio (LMR) in forecasting the clinical outcome for gastric cancer managed with triple modality induction.

Methods: Participants were given two cycles of docetaxel, fluorouracil and cisplatin (TPF), succeeded by radiation (45 Gy) alongside concurrent fluorouracil plus taxotere, then finally surgical resection. The designated baseline prognosticators were linked with clinical-pathological factors. Their contribution to outcome were assessed using Log rank and Cox regression.

Results: The study’s analysis revolved around 80 eligible participants. The triple modality induction ensued 22.5% complete response (PCR) alongside 47.5% and 42.5% 3-years estimated overall (OS) and disease-free survival (DFS), respectively. The receiver operator curves (ROC) cutoffs for baseline biomarker were registered at 2.4 (NLR), 1.7(dNLR), 5.1 (LMR) and 130 (PLR). Augmented prognosticators, stage III, R1 resection and >10 % residual tumor were substantially linked to worsened OS and DFS. Interestingly, the augmented dNLR and NLR were self-directed forecasters for deteriorating OS hazard ratio (HR) 2.04 (95% CI= 2.41-8.24), 6.63 (95% CI, 1.61-10.32) and DSF with (HR) 1.84 (95% CI= 3.27-7.36), 4.63 (95% CI= 3.61-12.12), respectively. None of the participants succumbed secondary to treatment toxicities although grade 4 side effects were attained by 20% of cases.

Conclusion: The triple modality induction in resectable gastric cancer is feasible with promising outcomes. The baseline inflammatory prognosticators attained a notable statistical link to many clinical/pathological variables. Moreover, NLR and dNLR behaved as autonomous indicators of clinical consequences for patients with gastric cancer managed with triple preoperative modality.