The importance of the novel gastric cancer prognostic index in patients with locally advanced gastric cancer who underwent radical gastrectomy and chemoradiotherapy

Abstract

Aim: The significance of the novel gastric cancer prognostic index, hich combines albumin and metastatic lymph node count, on the outcomes of patients with locally advanced gastric cancer who received radical gastrectomy and concurrent chemoradiotherapy, was investigated. Method: Patients who between January 2014 and December 2019 were included in this retrospective analysis. According to the literature, the ideal cutoff value for albumin was determined to be 3.5 g/dL. While, the optimal cutoff for metastatic lymph node count was determined using receiver operating characteristic curve analysis. Results: This retrospective study comprised a total of 137 locally advanced gastric cancer patients. The ideal albumin cutoff was chosen to be the classically referred 3.5 g/dL (<3.5 versus ≥3.5 g/dL), while the results of the receiver operating characteristic curve analysis revealed the ideal metastatic lymph node count cutoff as 5 (<5 versus ≥5). Hence, the study population was divided into four possible groups: Group-1: albumin ≥3.5 g/dL and metastatic lymph node count <5, Grup-2: albumin ≥3.5 g/dL and metastatic lymph node count ≥5, Grup- 3: albumin <3.5 g/dL and metastatic lymph node count <5, and Grup-4: albumin <3.5 g/dL and metastatic lymph node count ≥5. Since of groups 2 and 3 were statistically indistinguishable, we merged them into a single group to create gastric cancer prognostic index-2. The Kaplan-Meier curves revealed that the gastric cancer prognostic index-1 and gastric cancer prognostic index-3 represented progression-free (66.0 versus 16.4 months; p<0.001) and overall survival (66.0 versus 19.5 months, p<0.001) respectively. The results of the multivariate analysis confirmed the gastric cancer prognostic index grouping's independent prognostic significance for overall (p<0.001) and progression-free survival (p=0.05) outcomes. Conclusion: The findings of this study gastric cancer prognostic index may be utilized as an independent and precise prognostic indicator.