Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan,
Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Oncology. 2021;99(6):380-388. doi: 10.1159/000514572. Epub 2021 Mar 5.
The Japanese Gastric Cancer Treatment Guidelines recommend S-1 and S-1 plus docetaxel as postoperative chemotherapy for pathological stage II and III gastric cancer (GC). There is currently no strategy for using chemotherapy to treat high-risk recurrent pathological stage II/III. Previous studies reported that the several nutritional, immunological, and inflammatory markers examined the association with clinical outcomes after surgery for GC.
Ninety patients with GC (stage II, n = 48; stage III, n = 42) for whom gastrectomy was performed at our institution between November 2009 and September 2018 were examined. Nutritional, immunological, and inflammatory markers were calculated from blood samples within 1 week before surgery.
The prognostic nutritional index (PNI) status correlated with the pathological stage and disease recurrence after surgery (p = 0.015 and p < 0.0001, respectively). Thirty-three patients had disease recurrence after gastrectomy (stage II, n = 11; stage III, n = 22). The PNI was significantly lower in the recurrent group than in the non-recurrent group (p = 0.0003). The PNI correlated with overall survival and recurrence-free survival after gastrectomy (p = 0.0021 and p = 0.0001, respectively). A multivariate analysis identified the PNI as an independent prognostic factor (p = 0.006).
The PNI may be useful for predicting the outcomes of patients with pathological stage II/III GC and may contribute to the selection of an appropriate adjuvant chemotherapy regimen.
日本胃癌治疗指南推荐 S-1 和 S-1 联合多西他赛作为病理分期 II 和 III 期胃癌（GC）的术后化疗。目前尚无使用化疗治疗高危复发性病理分期 II/III 期的策略。先前的研究报告了几种营养、免疫和炎症标志物与 GC 手术后的临床结果相关。
我们检查了 2009 年 11 月至 2018 年 9 月期间在我院行胃切除术的 90 例 GC 患者（分期 II，n=48；分期 III，n=42）。从手术前 1 周内的血液样本中计算营养、免疫和炎症标志物。
预后营养指数（PNI）状态与手术后的病理分期和疾病复发相关（p=0.015 和 p<0.0001）。33 例患者在胃切除术后出现疾病复发（分期 II，n=11；分期 III，n=22）。复发组的 PNI 明显低于非复发组（p=0.0003）。PNI 与胃切除术后的总生存和无复发生存相关（p=0.0021 和 p=0.0001）。多变量分析确定 PNI 是独立的预后因素（p=0.006）。
PNI 可能有助于预测病理分期 II/III 期 GC 患者的结局，并有助于选择适当的辅助化疗方案。
