29 - Prognostic Value of Systemic Inflammatory Markers in Patients With Gastric Adenocarcinoma

Tuesday, October 25, 2022

8:40 AM – 8:50 AM ET

Location: Hall C1

Presenting Author(s)

OA

Osama Abu-Shawer, MD, MS

Cleveland Clinic
Cleveland, OH

PDF of Slides View Slides

Osama Abu-Shawer, MD, MS¹, Khaled Alsabbagh Alchirazi, MD¹, Ashraf Almomani, MD², Somtochukwu Onwuzo, MD², Motasem Alkhayyat, MD², Thabet Qapaja, MD¹
¹Cleveland Clinic, Cleveland, OH; ²Cleveland Clinic Foundation, Cleveland, OH

Introduction: Recent studies have shown the role of inflammatory markers, especially the neutrophil-to-lymphocyte Ratio (NLR), as indicators of poor prognosis in various gastrointestinal malignancies. We aimed to examine the prognostic value of NLR, among other markers, and their relationship with the presence of baseline distant metastasis in patients with gastric adenocarcinoma.

Methods: We retrospectively reviewed the charts of 502 patients with gastric adenocarcinoma treated at a tertiary care cancer center from 2012 to 2018. We examined the relationship between absolute eosinophilic count (AEC), absolute lymphocyte count (ALC), absolute monocytic count (AMC), absolute neutrophil count (ANC), monocyte to lymphocyte ratio (MLR), NLR, and platelet to lymphocyte ratio (PLR) with the presence distant metastases, and overall survival (OS). We used multivariable logistic regression analyses to test the association between the variables and the presence of baseline distant metastases.

Results: The median age was 54 years, and males comprised 56% of the patients. The ROC value of 3.9 was determined as the cutoff value for NLR. High NLR (NLR > 3.9 µL) was significantly associated with the presence of distant metastasis at diagnosis (p-value: 0.0001, OR: 0.5, 95% CI: 0.3–0.7). High ANC (≥6015/μL), AEC (≥215 /μL), and PLR (≥0.15) were significantly associated with baseline distant metastases (p-value: 0.024, 0.001, and 0.001 respectively). Multivariable analysis showed that high NLR (p-value, 0.0005, OR: 0.5, CI: 0.32–0.74) was an independent risk factor for distant metastasis at presentation. High baseline ANC, NLR, MLR, and PLR were associated with poor OS (p-value: 0.0455, 0.0003, 0.0270, and < 0.0001, respectively).

Discussion: High systemic inflammatory markers are associated with poor prognosis (the presence of distant metastasis) and poor OS in patients with gastric cancer. Simple laboratory tests such as complete blood counts can be used as markers of poor prognosis and poor OS in patients with gastric cancer.

Figure: Figure-1; Kaplan Meier curve for overall survival with NLR
Figure-2; Kaplan Meier curve for overall survival with MLR
Figure-3; Kaplan Meier curve for overall survival with PLR

	Baseline distant metastases
	Present	Absent	p- value	OR	95% CI
ANC≥6000	97 (39%)	154 (61%)	0.024	0.65	(0.4-0.9)
ANC< 6000	73 (29%)	178 (71%)
ALC≥2000	83 (33%)	168 (67%)	0.7	1.0	(0.7-1.6)
ALC< 2000	87 (34%)	164 (66%)
AMC≥ 660	92 (37%)	159 (63%)	0.19	0.8	(0.5-1.1)
AMC< 660	78(31%)	173 (69%)
AEC≥ 215	98(67.6%)	151 (61%)	0.001	0.5	(0.3-0.8)
AEC< 215	47(25%)	142 (75%)
NLR≥3.9	86 (44%)	110 (56%)	0.0001	0.5	(0.3-0.7)
NLR< 3.9	84 (27%)	222 (73%)
MLR≥0.3	89 (35%)	162 (65%)	0.45	0.9	(0.6-1.3)
MLR< 0.3	81(32%)	170 (68%)
PLR≥0.15	98 (40%)	150 (60%)	0.001	0.5	(0.3-0.8)
PLR< 0.15	57 (25%)	171 (75%)

Table: The association between systemic inflammatory markers with the presence of distant metastases

Disclosures:

Osama Abu-Shawer indicated no relevant financial relationships.

Khaled Alsabbagh Alchirazi indicated no relevant financial relationships.

Ashraf Almomani indicated no relevant financial relationships.

Somtochukwu Onwuzo indicated no relevant financial relationships.

Motasem Alkhayyat indicated no relevant financial relationships.

Thabet Qapaja indicated no relevant financial relationships.

Osama Abu-Shawer, MD, MS¹, Khaled Alsabbagh Alchirazi, MD¹, Ashraf Almomani, MD², Somtochukwu Onwuzo, MD², Motasem Alkhayyat, MD², Thabet Qapaja, MD¹, 29, Prognostic Value of Systemic Inflammatory Markers in Patients With Gastric Adenocarcinoma, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.