Significance of Preoperative Systemic Inflammation Score in Short-Term and Long-Term Outcomes of Patients with Pathological T2-4 Gastric Cancer After Radical Gastrectomy

World J Surg. 2018 Oct;42(10):3277-3285. doi: 10.1007/s00268-018-4597-7.

Abstract

Background: Surgical resection is the mainstay of treatment for patients with gastric cancer (GC). Development of a simple, high-performance, integrated scoring system is needed to provide appropriate management. This study aimed to evaluate predictive values of the systemic inflammation score (SIS) for short- and long-term outcomes of patients who underwent surgery for GC.

Methods: A total of 187 patients who underwent gastrectomy for pT2-4 GC without preoperative treatment were analyzed. SIS was formulated based on serum albumin level and lymphocyte-monocyte ratio, and graded into SIS 0, 1, and 2.

Results: Preoperative SIS was significantly associated with incidence of postoperative complications, showing a stepwise increased incidence in proportion to SIS in the entire cohort and all subgroups according to operative procedure and disease stage. Overall and disease-free survival times of patients in SIS 0, 1, and 2 shortened in a stepwise fashion. SIS was linked to prevalence of hematogenous metastasis as initial recurrence site. Survival differences between patients with SIS 2 and the others were particularly large in patients who underwent adjuvant chemotherapy. The continuation rate of adjuvant S-1 was lower in the SIS 2 group.

Conclusion: SIS represents a simple predictor for incidence of postoperative complications and survival in patients with pT2-4 GC.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Gastrectomy* / adverse effects
  • Humans
  • Incidence
  • Inflammation / complications*
  • Inflammation / diagnosis
  • Leukocyte Count
  • Lymphocytes
  • Male
  • Middle Aged
  • Monocytes
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology*
  • Postoperative Complications / therapy
  • Preoperative Period
  • Serum Albumin / analysis
  • Stomach Neoplasms / complications
  • Stomach Neoplasms / mortality
  • Stomach Neoplasms / surgery*
  • Survival Analysis
  • Treatment Outcome
  • Young Adult

Substances

  • Serum Albumin