Preoperative evaluation of prognostic factors in advanced gastric cancer patients undergoing gastro-jejunostomy

Abstract

The aim of this study is to assess the value of ECOG-PS (PS), Glasgow Prognostic Score (GPS), Prognostic Nutrition Index (PNI) and Neutrophil/Lymphocyte Ratio (NLR) as prognostic scores in advanced gastric cancer patients undergoing gastro-jejunostomy. We retrospectively reviewed the medical records of 74 advanced gastric cancer patients treated with gastro-jejunostomy in two institutions.
The median overall survival (OS) was 287 days and 218 days in PS 0,1 and PS 2, respectively. There were no significant differences in OS (p=0.288). The group with a GPS of 2 was associated with a significantly shorter OS compared to the group with a GPS 0,1 (OS: 122 days vs. 294 days; p<0.0001). The group with a PNI<40 was associated with a significantly shorter OS compared to the group with a PNI>40 (OS: 193 days vs. 305 days; p=0.0088). The group with a NLR>3 was associated with a significantly shorter OS compared to the group with a NLR<3 (OS: 188 days vs. 294 days; p=0.0491). Multivariate analyses were performed to evaluate the factors that affected OS. These analyses showed that GPS 2 (HR 3.448, 95% CI: 1.413-8.416, p=0.0065) was the independent prognostic factor for a shorter OS. PS2 (HR 1.067), PNI<40 (HR 1.111) and NLR>3 (HR 0.960) were not significant independent predictors of survival.
The present study suggests that GPS predicts overall survival in advanced gastric cancer patients undergoing gastro-jejunostomy.