Prognostic value of inflammatory markers in predicting recurrence-free survival in gastrointestinal stromal tumor patients: A nomogram-based approach

Abstract

BACKGROUND

There are currently no relevant studies at home or abroad that combine inflammatory indicators and nomograms to predict the prognosis of gastrointestinal stromal tumor (GIST) patients after surgery. The purpose of this study was to investigate the predictive value of related inflammatory indicators [systemic immune-inflammation index (SII), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and monocyte/Lymphocyte ratio (MLR)] in patients undergoing GIST surgery, incorporating relevant risk factors to establish a nomogram prediction model, with the aim of better predicting the prognosis of GIST patients.

AIM

To explore the relationships between the SII, NLR, PLR, and MLR and postoperative recurrence in patients with GIST.

METHODS

This study retrospectively included patients who underwent GIST surgery from January 2014 to January 2017 and analyzed the potential relationships between the preoperative SII, NLR, PLR, and MLR and clinicopathological features. The independent risk factors influencing the prognosis of GIST patients were obtained via multivariate regression analysis, and a nomogram model based on the independent risk factors was established.

RESULTS

Among the 124 GIST patients included in the present study, 31 (25%) experienced recurrence within 5 years. Kaplan-Meier survival analysis revealed a correlation between the MLR and PLR and tumor size (P = 0.016 and P = 0.002, respectively). The preoperative SII, MLR, NLR, and PLR were significantly associated with recurrence-free survival (RFS) (P < 0.05). The multivariate analysis results identified the PLR, MLR, and targeted therapy as independent prognostic factors for patient outcomes.

CONCLUSION

Preoperative MLR and PLR, which are independent risk factors for GIST recurrence, were correlated with RFS. Nomograms based on the PLR, MLR and targeted therapy can be used for clinical treatment.

Keywords: Gastrointestinal stromal tumor; Inflammatory index; Prognosis; Nomogram; Systemic immune-inflammation index

Core Tip: This study revealed significant correlations between preoperative inflammatory markers [systemic immune-inflammation index, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio (PLR) and monocyte/Lymphocyte ratio (MLR)] and recurrence-free survival in gastrointestinal stromal tumor (GIST) patients. The MLR and PLR were identified as independent risk factors for GIST recurrence. Research has highlighted the prognostic relevance of inflammatory markers in various cancers. Nomograms have been utilized in predicting survival and recurrence in different cancers. This study pioneered the construction of a nomogram based on inflammatory markers for assessing the recurrence risk prognosis in GIST patients. The nomogram demonstrated utility in predicting GIST patient recurrence risk, emphasizing the ongoing sensitivity of inflammatory markers in patients receiving postoperative targeted therapy.