B09 - A prognostic model using inflammatory response markers in metastatic gastric cancer (GC) pts before first-line chemotherapy

Abstract

Background: The outcome of metastatic gastric cancer is still poor. Recent studies have shown that systemic inflammatory response markers such as NLR and PLR affect survival of GC pts. This study was carried out to create a prognostic model using inflammatory-based scores to predict survival in patients with metastatic GC before chemotherapy. Methods: We studied the prognostic value of systemic inflammatory factors such as circulating white blood cell count and its components in 110 pts with metastatic GC receiving first-line chemotherapy. NLR and PLR were determined before starting chemotherapy. Median value was used to determine the cut-off levels for these biomarkers. Univariate and multivariate analyses were performed to examine the impact of inflammatory markers on overall survival (OS). Statistical analysis was performed by SPSS 21.0 software. Results: The median values of NLR and PLR were 2.22 (95% Confodence Interval (CI): 0.36-18.46) and 157.01 (95% CI: 32.79-720), respectively. Pts were divided into two groups according to the cut-off values (NLR: <2.22 and ≥2.22; PLR: < 157.01 and ≥157.01). Median OS was significantly lower in pts with NLR ≥2.22 or PLR ≥157.01 (7 vs 15 months in both groups, p: < 0.0001). Univariate analysis demonstrated that ECOG PS 2, NLR ≥2.22 and PLR ≥157.01 were significant predictors of shorter OS. Multivariate analysis confirmed all these factors as independent predictors of poor OS. Based on these results, we definied a prognostic score: pts were classified into favorable (0 risk factors), intermediate (1 risk factor) and poor-risk groups (≥2 risk factors) according to these parameters. The median OS was 16 (95% CI: 10.5-21.5) vs 11 (95% CI: 9.45-12.54) vs 6 (95% CI: 4.24-7.75) months in favorable, intermediate, and poor-risk groups, respectively. Conclusions: this study suggests that elevated pretreatment NLR and PLR are indipendent predictors of short survival in metastatic GC patients before first line chemotherapy.