An Evaluation of the Effect of Preoperative Inflammation-based Factors on Survival in Gastric Cancer Patients.

Abstract

To investigate the predictive effect of preoperative inflammatory factors on overall survival (OS) in patients diagnosed with gastric adenocarcinoma (GAC). Observational study. Department of General Surgery, Ankara Training and Research Hospital, between January 2011 and October 2020. A retrospective examination of 207 patients was made from the demographic, preoperative, and postoperative clinical pathology records of patients diagnosed with GAC. Demographic data, pathological tumor-node-metastasis (TNM) staging, preoperative inflammatory factors including neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and aspartate transaminase (AST)-alanine aminotransaminase (ALT) ratio, red cell distribution width (RDW), and hypoalbuminemia were statistically analysed in respect of the effect on OS. Overall survival was determined to be significantly shorter in patients with age >65 years (p = 0.001), advanced TNM stage (p <0.001), tumor size >4.7 cm (p = 0.007), AST-ALT ratio >1.21 (p = 0.017), and hypoalbuminemia (<35 g / L) (p = 0.018). In Cox regression analysis for all factors affecting OS, age >65 years (p = 0.002) and TNM stage 1B (p = 0.004) and 2A (p = 0.039) were determined as independent predictors of survival. The values of NLR, PLR, and RDW were not statistically significant between the groups with and without mortality (p=0.066, p=0.283, p=0.501, respectively). Inflammation-based factors including AST-ALT ratio and albumin can help assess prognosis in patients with gastric cancer in standard clinical preoperative tests. Key Words: Gastric cancer, Inflammation-based factors, Aspartate transaminase-alanine aminotransaminase ratio, Neutrophil-lymphocyte ratio, Platelet-lymphocyte ratio, Albumin, Tumor-node-metastasis staging, Overall survival.