Prognostic Importance of the Preoperative Naples Prognostic Score for Patients With Adenocarcinoma of the Esophagogastric Junction

Abstract

BackgroundThe naples prognostic score (NPS) is established according to nutritional or inflammatory state, and it is identified as the new prognostic score for a variety of malignant tumors. However, its significance in cases suffering from adenocarcinoma of esophagogastric junction (AEJ) who receive surgery remains unclear so far.MethodsIn this study, patients receiving surgery without preoperative therapy were examined between June 2007 and August 2017 in a retrospective way. Typically, the serum albumin level, total cholesterol level, neutrophil-to-lymphocyte ratio, together with the lymphocyte-to-monocyte ratio, was determined to calculate the NPS. The prognostic impact of NPS was evaluated using survival analyses. Time-dependent receiver operating characteristic curve (t-ROC) analysis was also carried out for comparing prognostic impacts of those scoring systems.ResultsAltogether 231 cases were enrolled in this study. A higher NPS showed positive correlation with perineural invasion. Upon multivariate analysis, NPS was identified to be the independent prognostic factor to predict overall survival (OS) along with relapse-free survival (RFS) (both P< 0.05), and an especially strong correlation was observed at advanced pTNM stages based on NPS system. As for subgroup analyses on adjuvant chemotherapy or surgery only, NPS still independently predicted the OS as well as RFS (both P< 0.05) in both groups. Furthermore, t-ROC analysis showed that NPS was more accurate than the systemic inflammation score in predicting OS and RFS.ConclusionsThe NPS represents the simple and useful rating system, which can independently predict the survival for AEJ cases undergoing surgery.

Naples Prognostic Score Predicts Tumor Regression Grade in Resectable Gastric Cancer Treated with Preoperative Chemotherapy

“…We have recently demonstrated that NPS is a powerful predictor of long-term survival both in colorectal- and gastric-cancer patients [ 32 , 33 ]. Subsequently, many independent studies from different parts of the world, have shown that NPS is significantly correlated with oncological outcome in several human tumors including lung, endometrial, pancreatic, and gastro-esophageal cancers [ 28 , 50 , 51 , 52 , 53 ]. This is not surprising because NPS includes the neutrophil-to-lymphocyte and the lymphocyte-to-monocyte ratios which have been shown to be reliable surrogate indicators of the host inflammatory and immunological status [ 54 , 55 ].…”

Controlling Nutritional Status (CONUT) Predicts Survival in Gastric Cancer Patients With Immune Checkpoint Inhibitor (PD-1/PD-L1) Outcomes

“…Moreover, cachexia, as a complex and multifactorial syndrome, affects about 50%-80% of cancer patients and is related to 20%-40% of cancer deaths (Freire et al, 2019). Multiple nutritional assessment systems, including Naples Prognostic Score (NPS), Nutritional Risk Screening (NRS), body mass index (BMI), albumin (ALB), and prognostic nutritional index (PNI), have emerged with the aim of detecting and predicting the clinical outcomes of gastric cancer patients (Li et al, 2019;Wu et al, 2019;Bae, 2020;Park et al, 2020;Xiong et al, 2020). It is also reported that immunological status is associated with the patient's prognosis (Sato et al, 2020).…”

Naples prognostic score, a novel prognostic score for patients with high- and intermediate-risk gastrointestinal stromal tumours after surgical resection

“…However, the creator of the scoring system said that patients with the worst Naples prognostic score experienced more postoperative complications, and our study does not support this conclusion [ 18 ]. Similarly, two of the subsequently published articles had the same conclusions as ours [ 20 , 21 ], and the remaining articles did not list data related to postoperative morbidity [ 19 , 22 – 25 ]. This finding may be related to the careful supervision and continuous maintenance of the patient’s immune-nutritional status by attending physicians during hospitalization.…”

“…Most recently, a novel multidimensional comprehensive prognostic evaluation system, the Naples prognostic score (NPS), was established based on albumin, total cholesterol, NLR, and lymphocyte-monocyte ratio (LMR) although a prospective clinical trial [18]. This scoring system has been reported in oesophageal cancer, lung cancer, pancreatic cancer, colorectal cancer, endometrial cancer, osteosarcoma, and gastric cancer, which is of great significance [19][20][21][22][23][24][25]. However, the role of NPS in patients with GISTs remains unclear.…”