Prognostic importance of the preoperative New‐Naples prognostic score for patients with gastric cancer

Abstract

Background The wide applicability of the Naples prognostic score (NPS) is still worthy of further study in gastric cancer (GC). This study aimed to construct a New‐NPS based on the differences in immunity and nutrition in patients with upper and lower gastrointestinal tumors to help obtain an individualized prediction of prognosis. Methods This study retrospectively analyzed patients who underwent radical gastrectomy from April 2014 to September 2016. The cutoff values of the preoperative neutrophil‐to‐lymphocyte ratio (NLR), lymphocyte‐to‐monocyte ratio (LMR), serum albumin (Alb), and total cholesterol (TC) were calculated by ROC curve analysis. ROC and t‐ROC were used to evaluate the accuracy of the prognostic markers. The Kaplan–Meier method and log‐rank test were used to analyze the overall survival probability. Univariate and multivariate analyses based on Cox risk regression were used to show the independent predictors. The nomogram was made by R studio. The predictive accuracy of nomogram was assessed using a calibration plot, concordance index (C‐index), and decision curve. Results A total of 737 patients were included in training cohort, 411 patients were included in validation cohort. ROC showed that the New‐NPS was more suitable for predicting the prognosis of GC patients. NPS = 2 indicated a poor prognosis. Multivariate analysis showed that CEA (P = 0.026), Borrmann type (P = 0.001), pTNM (P < 0.001), New‐NPS (P < 0.001), and nerve infiltration (P = 0.035) were independent risk factors for prognosis. Conclusion The New‐NPS based on the cutoff values of NLR, LMR, Alb, and TC is not only suitable for predicting prognosis but can also be combined with clinicopathological characteristics to construct a nomogram model for GC patients.

Clinical Implications of Naples Prognostic Score for Patients with Resected Cholangiocarcinoma: A Real-World Experience

“… 23 , 24 Notably, NPS has been found to possess a better prognostic value compared to other markers in esophageal cancer and gastric cancer. 12 , 13 In our study, the ROC curves demonstrated that NPS exhibited a higher prognostic value in both the training group and the validation group.…”

“…It was initially confirmed as an independent risk factor in colon cancers and further demonstrated its correlation with prognosis in esophageal cancer, pancreatic cancer, gastric cancer, and other types of cancers. [11][12][13][14] However, the predictive significance of NPS in patients with CCA has not yet been confirmed.…”

The Naples Prognostic Score Is an Independent Prognostic Factor for Gastric Cancer Patients Who Receive Curative Treatment

“…Therefore, future studies should reconstruct the New-NPS according to the nutritional status of patients with gastric cancer. Wang et al evaluated the new-NPS as a prognostic factor in patients with gastric cancer (25). In that study, the cutoff values used were 2.37 for NLR, 3.10 for LMR, 4.25 for albumin, and 156.81 for total cholesterol.…”

The new score predicts 1-year poor outcome in patients with successful percutaneous coronary intervention: Naples prognostic score

“…To determine the NPS score, all of these scores are added together. 6 In the study, patients were categorized into two groups based on their NPS score: those with a score of 0.1 to 2, and those with a score of 3 to 4. Major cardiovascular event (MACE) was defined as 1-year all-cause mortality, 1-year stroke, nonfatal recurrent MI, stroke, and MACEs were compared between the groups.…”

“…It has previously been used as a valuable prognostic tool in cancer patients. 6 NPS provides nutritional status and inflammation information. The long-term prognostic value of NPS has been previously demonstrated in a study of ST-segment elevation myocardial infarction (STEMI) patients.…”