Preoperative sarcopenia combined with prognostic nutritional index predicts long-term prognosis of radical gastrectomy with advanced gastric cancer: a comprehensive analysis of two-center study

Abstract

Purpose This study aims to investigate the predictive value of the combined index smni(skeletal muscle index (SMI)-prognostic nutrition index(PNI)) for the postoperative survival of patients with advanced gastric cancer(AGC). Methods 650 patients with AGC from two centers (290 cases from the First Affiliated Hospital of Dalian University and 360 points from the Fujian Medical University Union Hospital) were selected as the study subjects based on unified screening criteria. Clinical data, preoperative abdominal CT images, results of hematology-related examinations, tumor-related characteristics, and surgical and follow-up data of the patients were collected and organized. The L3 vertebral level muscle area was measured using computer-assisted measurement techniques, and the skeletal muscle index(SMI) was calculated based on this measurement. The prognostic nutrition index (PNI) was calculated based on serum albumin and lymphocyte count indicators. The Kaplan-Meier survival analysis of data from the First Affiliated Hospital was used to determine that SMI and PNI are significantly correlated with the postoperative survival rate of patients with advanced gastric cancer. Based on this, a novel combined index smni was fitted and stratified for risk. Cox proportional hazards regression analysis was used to determine that the index smni is an independent prognostic risk factor for patients with AGC after surgery. The ROC curve was used to describe the predictive ability of the new combined index and its importance and predictive power in predicting postoperative survival of patients with AGC, which was verified in the data of Fujian Medical University Union Hospital. Result The Kaplan-Meier curve analysis of the combined indicator smni Is clearly associated with long-term survival(3-year OS (P < 0.001) and DSS (P < 0.001)), univariate analysis and multivariate analysis showed that smni was an independent prognostic risk factor, The ROC curve for the first center 3-year OS(AUC = 0.678), DSS(AUC = 0.662) show good predictive ability and were validated in the second center. Conclusion The combined index smni has a good predictive ability for the postoperative survival rate of patients with AGC and is expected to provide a new reference basis and more accurate and scientific guidance for the postoperative management and treatment of patients with AGC.

Quality of Life, Sarcopenia and Nutritional Status in Patients with Esophagogastric Tumors before and after Neoadjuvant Therapy

“…Sarcopenia and HRQoL are established risk factors for poor survival and tumor growth in upper GI tumors [ 10 , 12 , 19 , 41 , 62 , 63 , 64 , 65 , 66 , 67 ]. Sarcopenia has traditionally been measured through the CT-graphically obtained SMI, while HRQoL is obtained through patient questionnaires.…”

The Geriatric Nutritional Risk Index Predicts Prognosis in Japanese Patients with LATITUDE High-Risk Metastatic Hormone-Sensitive Prostate Cancer: A Multi-Center Study

“…When compared with GNRI, most patients that were divided by an Alb level cutoff were categorized as being in the Alb-high group (134 and 41 in high and low groups, respectively, for Alb; vs. 109 and 66 in high and low groups, respectively, for GNRI). Considering the substantial contribution of the Alb level to predicting OS in this study, and recent evidence on the efficacy of complex biomarkers, including serum Alb [21,22], the GNRI was therefore selected for this study. With regard to prolonged TTCR, the following were revealed in univariate analysis to be independent prognostic factors when initial treatment was started: existence of symptoms (HR: 1.87, 95% CI: 1.16-3.03), upfront AA treatment (HR: 0.38, 95% CI: 0.24-0.60), low CRP level (HR: 0.45, 95% CI: 0.28-0.74), and high GNRI (HR: 0.44, 95% CI: 0.28-0.69).…”