The inflammatory prognostic index as a potential predictor of prognosis in metastatic gastric cancer
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Ahmet Özveren, Atike Pınar Erdoğan, Ferhat Ekinci
When stomach cancer has already spread, doctors need clues about how the illness may unfold. This study suggests that information already present in a routine blood test could help separate higher-risk patients from lower-risk patients.
Clinical studies aimed at identifying effective and simple prognostic markers for gastric cancer are still being carried out. Inflammatory prognostic index (IPI) is being recognized as a promising prognostic marker in patients with Non-Small Cell Lung Cancer. To evaluate the prognostic utility of IPI in stage 4 gastric cancer. A total of 152 patients with stage 4 gastric cancer, whose laboratory parameters, progression-free survival (PFS) and overall survival (OS) data could be accessed, were evaluated. Kaplan Meier analysis was used for survival analyses. Hazard ratios were expressed with 95% CI values. All methods were performed in accordance with the relevant guidelines and regulations. Study was approved by the Manisa Celal Bayar University’s Non-Invasive Clinical Research Ethics Committee (approval No. E-85252386-050.04.04-49119, date: 22.03.2021). We confirm that all methods were performed in accordance with relevant named guidelines and regulations. Median age at diagnosis was 63 years (range: 32–88). The number of patients who received first-line chemotherapy was 129 (84.9%). Median PFS with first-line treatment was 5.3 months, while it was 3.3 months with secondline treatment. Median OS was 9.4 months. Median IPI score was 22.2. We evaluated IPI score for its value in detecting survival status with ROC analysis and identified an IPI cut-off score of 14.6. Low IPI score was significantly associated with longer PFS and OS compared to high IPI (PFS in high vs. low IPI, 3.6 vs. 7 months; p < 0.001) (OS in high vs. low IPI, 6.6 vs. 14.2 months; p < 0.001). IPI score can be an independent prognostic index that is inexpensive, easy to access and evaluate for patients with metastatic gastric cancer, and may be useful in predicting survival in daily practice.
Transcript
When stomach cancer has already spread, doctors need clues about how the illness may unfold. This study suggests that information already present in a routine blood test could help separate higher-risk patients from lower-risk patients.
Gastric cancer is the fifth most common cancer and the third most common cause of cancer-related death. Cancer-associated inflammation is associated with tumor development and spread. Some inflammation markers made from blood measurements can help predict shorter survival or resistance to chemotherapy.
But the link between inflammation and cancer is strong and complex. So the central question was whether inflammatory prognostic index values are associated with progression-free survival and overall survival in people with stage-four gastric cancer. Think of it like a dashboard warning light in a car: it does not explain every problem under the hood, but it may signal that the journey ahead is more difficult.
The study looked back at people diagnosed with metastatic gastric cancer between 2013 and 2020. Their laboratory results, survival information, treatments, and general condition were recorded. The first blood tests were obtained before treatment, so the treatment would not affect the laboratory and performance results being examined.
A lower inflammatory prognostic index score was significantly associated with longer overall survival and longer progression-free survival than a higher score. The index classification was also identified as an independent prognostic factor for both overall survival and progression-free survival.
For people with advanced stomach cancer, a simple risk score sharply separated expected survival: the lower-risk group lived a median of fourteen point two months, compared with six point six months for the higher-risk group. The analysis found that both the neutrophil-to-lymphocyte ratio and the inflammatory prognostic index were associated with survival status, measured through overall survival and progression-free survival.
The inflammatory prognostic index is described as reproducible, cost-effective, and available for people with gastric cancer. The inflammatory prognostic index was associated with progression-free survival and overall survival regardless of the preferred chemotherapy regimen.
It also seemed more sensitive than the neutrophil-to-lymphocyte ratio when predicting progression-free survival and overall survival. But this was a retrospective study conducted at two centers with a relatively small number of patients. The results should therefore be confirmed by studies that follow patients forward and include more people.
That caution matters because a useful warning signal still needs testing before it can guide decisions for everyone. The analysis determined that the inflammatory prognostic index could predict prognosis and survival in people with metastatic gastric cancer.
Because it is inexpensive and easy to access and evaluate, it may help predict survival in daily clinical practice. The inflammatory prognostic index was linked with both disease progression and overall survival, even across different chemotherapy choices.
It could offer an inexpensive, accessible aid for discussing risk in everyday care, though larger forward-looking studies are still needed.
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