Significance of Preoperative Systemic Immune Score for Stage I Gastric Cancer Patients

Abstract EN

Background.

Determining preferences regarding the benefits of adjuvant chemotherapy (AC) for stage I GC is critical.

Methods.

We retrospectively reviewed 1069 patients with pathologically confirmed stage I GC who underwent R0 gastrectomy between 2006 and 2014.

Univariate and multivariate survival analyses were conducted.

Systemic inflammation factors were used to develop a scoring system for predicting AC benefits.

Results.

With a median follow-up of 47 months (range 3–113 months), the 5-year overall survival (OS) rate was 90.5%.

The patient score was 1 for either a pretreatment hypoalbuminemia or elevated derived neutrophil-lymphocyte ratio (dNLR) and was 0 otherwise.

The SIS served as an independent prognostic factor for reduced OS.

AC was delivered to 13.5% (144/1069) of all patients.

Compared to surgery alone, AC had no significant effect on survival in both the entire cohort and the IA/IB subgroup.

However, in the high-risk group (SIS = 2), patients with AC had a significantly better OS than those undergoing surgery alone.

Conclusions.

Patients with SIS = 2 may benefit from AC and thus may be considered candidates for adjuvant treatment.

However, to confirm our findings, future prospective studies are warranted.