Abstract
Background. To clarify the efficacy of hepatectomy for gastric cancer liver metastasis (GCLM) and to investigate the association between prognostic nutrition index (PNI) or neutrophil-to-lymphocyte ratio (NLR) and prognosis of GCLM undergoing or without hepatectomy. Methods. We retrospectively studied 374 patients with GCLM. The ROC curve was used to determine the optimal cut-off of PNI and NLR. Patients were divided into groups based on whether hepatectomy was performed, and survival analysis was conducted before and after grouping. The overall survival (OS) time and 1, 3, 5-year survival rates were also compared. Results. Multivariate analysis of all GCLM patients revealed that hepatectomy (p = 0.001) was an independent prognosis factor. And there were statistical differences in OS and 1, 3, 5-year survival rates (p = 0.001 of all) between hepatectomy group and nonhepatectomy group. Multivariate analysis of GCLM undergoing hepatectomy showed that PNI was an independent prognosis factor (p = 0.001). And there were statistical differences in OS and 1, 3, 5‐year survival rates (p = 0.001p = 0.005, p = 0.001 and p = 0.020, respectively) between high PNI group and low PNI group. Multivariate analysis of GCLM without hepatectomy showed that NLR was an independent prognosis factor (p = 0.001). And there were statistical differences in OS and 1, 3, 5-year survival rates (p = 0.001p = 0.008p = 0.031 and p = 0.026, respectively) between low NLR group and high NLR group. Conclusions. GCLM has a better prognosis with hepatectomy. High preoperative PNI is a benign prognostic predictor for patients undergoing hepatectomy. And high preoperative NLR is an adverse prognostic factor for patients without hepatectomy.
Highlights
Gastric cancer (GC) is a kind of malignant tumor with high morbidity and mortality [1]
Liver is one of the most common metastatic sites, and liver metastasis is a major factor leading to poor prognosis for GC [2, 3]
Whether hepatectomy can improve the prognosis of gastric cancer liver metastasis (GCLM) is still not fully determined [6, 7]
Summary
Gastric cancer (GC) is a kind of malignant tumor with high morbidity and mortality [1]. Prognostic nutrition index (PNI) is calculated based on serum albumin level and total lymphocyte count in peripheral blood It is initially used as a re ection of nutritional status for cancer patients [8]. To clarify the e cacy of hepatectomy for gastric cancer liver metastasis (GCLM) and to investigate the association between prognostic nutrition index (PNI) or neutrophil-to-lymphocyte ratio (NLR) and prognosis of GCLM undergoing or without hepatectomy. Multivariate analysis of all GCLM patients revealed that hepatectomy ( = 0.001) was an independent prognosis factor. Multivariate analysis of GCLM undergoing hepatectomy showed that PNI was an independent prognosis factor ( = 0.001). Multivariate analysis of GCLM without hepatectomy showed that NLR was an independent prognosis factor ( = 0.001). High preoperative NLR is an adverse prognostic factor for patients without hepatectomy
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