Mide Kanseri Hastalarında İnflamatuar Parametrelerin Subtotal ve Total Gastrektomi Sonrası Sağkalımla İlişkisi

Abstract

This study aimed to assess the differences in inflammatory markers and modified Glasgow prognostic score (mGPS) among patients diagnosed with gastric cancer who underwent subtotal or total gastrectomy, and to evaluate the diagnostic performance of these markers in predicting prognosis. The study included 103 patients diagnosed with gastric cancer who had undergone subtotal (n:48) or total gastrectomy (n:55). The inflammatory indices were respectively calculated as follows: neutrophil to lymphocyte ratio (NLR) = neutrophil count / lymphocyte count, platelet to lymphocyte ratio (PLR) = platelet count / lymphocyte count, SII = platelet count × neutrophil count / lymphocyte count, C-reactive protein (CRP) to albumin ratio (CAR) = CRP / albumin levels. The mGPS was determined using established criteria based on CRP and ALB levels. The endpoint was the 3-year survival outcomes for all patients. The mean age of the patients included in the study was 65.9±9.7 years, and the vast majority were male (68.9%). The inflammatory indices did not demonstrate significant differences between the subtotal and total gastrectomy groups. Multiple Cox regression analysis showed that elevated SII (HR = 1.12, p < 0.001) were independent predictors of the 3-year mortality. In predicting the 3-year mortality, SII demonstrated superior diagnostic performance compared to other inflammatory indices (Area under the curve: 0.843, Sensitivity: 90.5% and Specificity = 67.1%). In patients with gastric cancer who have undergone subtotal and total gastrectomy, SII could serve as an important screening tool for predicting long-term prognosis, regardless of the surgical procedure.