Novel inflammatory-nutritional prognostic index for advanced gastric cancer patients undergoing gastrectomy and prophylactic hyperthermic intraperitoneal chemotherapy

Table 1 Relationship between the death within 3 years and clinicopathological characteristics of 181 advanced gastric cancer patients

Patients’ characteristics	No death (n = 97)	Death (n = 84)	χ2 value	P value
Sex			2.376	0.123
Male	64	46
Female	33	38
Age at diagnosis, years				< 0.001
< 60	55	9	41.651
≥ 60	42	75
NRS 2002			32.887	< 0.001
< 5	44	6
≥ 5	53	78
ASA score			1.960	0.581
1	1	0
2	53	44
3	42	40
4	1	0
pT stage			38.567	< 0.001
pT3	53	9
pT4	44	75
pN stage			68.524	< 0.001
N1	64	9
N2	24	26
N3	9	49
pTNM stage			38.140	< 0.001
II	40	2
III	57	82
Pathological tumor type			0.521	0.470
Adenocarcinoma	73	67
Mucinous adenocarcinoma or signet-ring cell carcinoma	24	17
Tumor site
Cardia/fundus	1	2	1.991	0.370
Body/angulus	28	31
Antrum/pylorus	68	51
Histological grade			0.062	0.804
G2	70	62
G3	27	22
Lymphovascular invasion			39.308	< 0.001
Yes	39	72
No	58	12
Surgical procedure			2.080	0.149
Open surgery	24	29
Laparoscopic surgery	73	55
Reconstruction method			0.283	0.868
Roux-en-Y	65	59
Billroth II + Braun	30	23
Billroth I	2	2
Extent of gastric resection			0.451	0.502
Distal	66	61
Total	31	23
Heat perfusion frequency			2.897	0.235
1	9	8
2	60	42
3	28	34
BMI (kg/m2)			30.885	< 0.001
< 22.1	8	37
≥ 22.1	89	47

BMI: Body mass index; NRS 2002: Nutritional Risk Screening 2002; ASA: American Society of Anesthesiologists; TNM: Tumor-node-metastasis.

Table 2 Relationship between the death within 3 years and inflammation and nutrition-related indicators of 181 advanced gastric cancer patients

Patients’ characteristics	No death (n = 97)	Death (n = 84)	χ2 value	P value
Hemoglobin (g/L)			14.660	< 0.001
< 119	37	56
≥ 119	60	28
Albumin (g/L)			16.099	< 0.001
< 34.38	19	40
≥ 34.38	78	44
Neutrophil count (× 109/L)			13.977	< 0.001
< 5.2	83	59
≥ 5.2	8	25
Lymphocyte count (× 109/L)			5.177	0.023
< 1.42	27	37
≥ 1.42	70	47
Monocyte count (× 109/L)			5.389	0.020
> 0.43	65	42
≤ 0.43	32	42
Platelet count (× 109/L)			0.305	0.581
< 324	13	9
≥ 324	84	75
NLR			14.625	< 0.001
< 3.11	82	50
≥ 3.11	15	34
PLR
< 159.3	55	29	8.902	0.003
≥ 159.3	42	55
LMR			5.288	0.021
< 3.34	30	40
≥ 3.34	67	44
SII			19.731	< 0.001
< 801.43	56	21
≥ 801.43	41	63
PNI			17.113	< 0.001
< 43.42	23	45
≥ 43.42	74	39
PAR			21.146	< 0.001
< 9.09	84	47
≥ 9.09	13	37
AGR			5.070	0.024
< 1.12	10	19
≥ 1.12	87	65
Globulin (g/L)			0.009	0.926
< 30.02	34	30
≥ 30.02	63	54

NLR: Neutrophil-lymphocyte ratio; PLR: Platelet-lymphocyte ratio; LMR: Lymphocyte-monocyte ratio; SII: Systemic immune inflammation index; PNI: Prognostic nutritional index; AGR: Albumin to globulin ratio; PAR: Platelet-albumin ratio.

Table 3 The cumulative recurrence rates and overall survival rates of 181 advanced gastric cancer patients undergoing gastrectomy and prophylactic hyperthermic intraperitoneal chemotherapy

Rates	1 year	2 years	3 years	Median OS
Overall survival rates	96.1%	75.1%	53.6%	41.3 months

OS: Overall survival.

Table 4 Univariate and multivariate analyses of baseline characteristics for overall survival in 181 advanced gastric cancer patients

Patients’ characteristics	Univariate analysis		Multivariate analysis
	HR (95%CI)	P value	HR (95%CI)	P value
Sex (male vs female)	0.78 (0.52-1.15)	0.209	0.94 (0.63-1.41)	0.780
Age at diagnosis, years (> 60 vs ≤ 60)	6.98 (3.92-12.4)	< 0.001	3.66 (1.97-6.80)	< 0.001
INPI groups
Medium risk vs low risk	3.23 (2.08-5.00)	< 0.001	3.70 (2.29-5.98)	< 0.001
High risk vs low risk	15.0 (8.17-27.57)	< 0.001	9.81 (4.97-19.37)	< 0.001
NRS 2002 (> 5 vs ≤ 5)	4.18 (2.40-7.29)	< 0.001	1.88 (1.03-3.40)	0.037
ASA score
2 vs 1	0.76 (0.10-5.56)	0.794
3 vs 1	0.86 (0.11-6.29)	0.888
4 vs 1	1.35 (0.08-21.75)	0.830
pT stage (pT4 vs pT3)	4.46 (2.68-7.42)	< 0.001	2.06 (1.08-3.94)	0.028
pN stage
N2 vs N1	3.70 (2.09-6.53)	< 0.001	3.77 (1.83-7.78)	< 0.001
N3 vs N1	9.83 (5.70-16.96)	< 0.001	6.69 (3.30-13.56)	< 0.001
pTNM stage (IV vs III)	6.93 (3.34-14.40)	< 0.001	1.49 (0.5-4.54)	0.477
Pathological tumor type
Mucinous adenocarcinoma or signet-ring cell carcinoma vs adenocarcinoma	1.07 (0.67-1.72)	0.758
Tumor site
Body/angulus vs cardia/fundus	1.09 (0.26-4.55)	0.901
Antrum/pylorus vs cardia/fundus	0.92 (0.22-3.78)	0.916
Histological grade (G3 vs G1/G2)	12.8 (0.80-2.04)	0.309
Lymphovascular invasion (yes vs no)	3.37 (2.13-5.32)	< 0.001	1.91 (1.17-3.13)	0.010
Surgical procedure (open surgery vs laparoscopic surgery)	1.25 (0.83-1.90)	0.279
Reconstruction method
Billroth II + Braun vs Roux-en-Y	1.068 (0.69-1.64)	0.763
Billroth I vs Roux-en-Y	0.894 (0.21-3.64)	0.876
Heat perfusion frequency
2 times vs 1 time	0.79 (0.40-1.55)	0.498
3 times vs 1 time	0.86 (0.58-2.34)	0.658
Extent of gastric resection (distal vs total)	0.98 (0.65-1.49)	0.946

HR: Hazard ratio; INPI: Inflammatory nutritional prognostic index; NRS 2002: Nutritional Risk Screening 2002; ASA: American Society of Anesthesiologists; TNM: Tumor-node-metastasis.