Which pretreatment immunonutritional index best predicts overall survival in elderly patients with locally advanced gastric cancer treated with perioperative FLOT therapy?

Creative Commons License

Melekoglu E., Mete B., Bayram E.

CLINICAL NUTRITION, cilt.63, sa.1057, ss.979-1311, 2024 (SCI-Expanded)

  • Yayın Türü: Makale / Özet
  • Cilt numarası: 63 Sayı: 1057
  • Basım Tarihi: 2024
  • Doi Numarası: 10.1016/j.clnesp.2024.07.248
  • Dergi Adı: CLINICAL NUTRITION
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, PASCAL, CAB Abstracts, CINAHL, EMBASE, Food Science & Technology Abstracts, Veterinary Science Database
  • Sayfa Sayıları: ss.979-1311
  • Çukurova Üniversitesi Adresli: Evet

Özet

Rationale: Recognizing immunonutritional risk factors holds significant importance in enhancing treatment efficacy and reducing mortality rates especially in geriatric cancer patients. We aimed to compare the utility of pretreatment immunonutritional indexes for predicting mortality in elderly patients with gastric cancer treated with perioperative FLOT. Methods: We conducted a retrospective enrollment (January 2013 - July 2023) of 69 locally advanced gastric cancer patients aged over 65 years who were treated with perioperative FLOT regimen. We compared the prognostic nutritional index (PNI), geriatric nutritional risk index (GNRI), platelet/lymphocyte ratio, lymphocyte/monocyte ratio, neutrophil/ lymphocyte ratio, platelet/hemoglobin ratio, CRP/albumin ratio, ferritin/ lymphocyte ratio (FLR), and ferritin/albumin ratio (FAR) for predicting postoperative mortality in these patients. Results: We determined that pretreatment PNI values were statistically significantly lower in patients who died during their follow-up (33.9±6.41 vs. 36.7±4.04; p¼0.036). Multivariable analysis identified only PNI as being associated with overall survival (HR, 0.884; 95% confidence interval, 0.782e0.999; p ¼ 0.048). The Cox regression model revealed that each one-unit increase (1%) in PNI caused an approximately 13% reduction in the risk of mortality. Conclusion: In conclusion, our results suggest that the PNI is a good pretreatment predictor of overall survival for elderly patients with gastric cancer treated with neoadjuvant FLOT