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

BACKGROUND Prophylactic hyperthermic intraperitoneal chemotherapy (HIPEC) is one of the methods to prevent peritoneal metastasis of advanced gastric cancer (AGC). However, the prognosis of gastric cancer patients who receive this treatment are different. AIM To investigate whether inflammation and n...

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Published inWorld journal of gastrointestinal surgery Vol. 17; no. 5; p. 102201
Main Authors Wang, Liang, Chen, Mei-Zhu, Liu, Lei, Jiang, Zi-Nian, Zhang, Si-Meng, Zhang, Mao-Shen, Zhang, Xian-Xiang, Liu, Rui-Qing, Wang, Dong-Sheng
Format Journal Article
LanguageEnglish
Published United States Baishideng Publishing Group Inc 27.05.2025
Subjects
Retrospective Study
Hyperthermic intraperitoneal chemotherapy
Inflammation
Prognosis
Nutrition
Gastric cancer
Nomogram
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Summary:BACKGROUND Prophylactic hyperthermic intraperitoneal chemotherapy (HIPEC) is one of the methods to prevent peritoneal metastasis of advanced gastric cancer (AGC). However, the prognosis of gastric cancer patients who receive this treatment are different. AIM To investigate whether inflammation and nutritional indicators affect the prognosis of AGC patients undergoing gastrectomy and prophylactic HIPEC, and to develop a novel inflammatory nutritional prognostic index (INPI). Additionally, we aimed to construct a nomogram model to visually predict the prognosis of these patients and provide more accurate guidance for clinical decision-making. METHODS Clinical data from 181 Locally AGC patients who underwent gastrectomy and prophylactic HIPEC treatment at The Affiliated Hospital of Qingdao University were retrospectively collected. Multicollinearity analysis and least absolute shrinkage and selection operator (LASSO) Cox regression were utilized to construct the INPI. Survival analyses were performed using the Kaplan-Meier method and log-rank test. Both univariate and multivariate Cox proportional hazards regression models were used to analyze independent prognostic factors, and a prognostic nomogram was generated. And the model was validated using the bootstrap method. RESULTS Clinical data from 181 locally AGC patients who underwent gastrectomy and prophylactic HIPEC treatment at The Affiliated Hospital of Qingdao University were retrospectively collected. Multicollinearity analysis and LASSO Cox regression were utilized to construct the INPI. Survival analyses were performed using the Kaplan-Meier method and log-rank test. Both univariate and multivariate Cox proportional hazards regression models were applied to analyze independent prognostic factors, and a prognostic nomogram was generated. And the model was validated using the bootstrap method. CONCLUSION Inflammation and nutrition indicators are associated with the prognosis of AGC patients undergoing gastrectomy and prophylactic HIPEC. The nomogram based on the INPI and clinical features supports personalized treatment strategies improving prognosis for AGC patients undergoing gastrectomy and prophylactic HIPEC.
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Corresponding author: Dong-Sheng Wang, MD, Professor, Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, No. 1677 Wutaishan Road, Huangdao District, Qingdao 266555, Shandong Province, China. wangdongsheng@qdu.edu.cn
Co-first authors: Liang Wang and Mei-Zhu Chen.
Author contributions: All authors read and approved the final manuscript; Wang DS, Liu RQ, Wang L, Chen MZ, Zhang MS, Zhang XX contributed to the study’s conception and design; Wang L, Liu L, and Jiang ZN were responsible for patient screening and data collection. Wang L, Chen MZ, and Zhang SM analyzed the data and made the figures and tables. Wang L, Chen MZ, and Liu RQ completed the first draft of the article. Wang DS, Liu RQ, Wang L, and Chen MZ participated in revising the manuscript before submission and during the formal revision. Wang L and Chen MZ contributed equally as co-first authors; During the creation and publication of this article, Liu RQ and Wang DS, as co-corresponding authors, made significant contributions to each key aspect. Wang DS took the lead in designing the research plan, ensuring its scientificity, feasibility, and innovation. Meanwhile, Wang DS was responsible for coordinating various resources to guarantee the smooth progress of the research work. Liu RQ was deeply involved in the experimental process, including specific tasks such as data collection and chart making. During the writing of the paper, Liu RQ systematically sorted out and analyzed the research results and wrote key chapters, making the expressions more accurate, fluent, and the logic more rigorous.
Co-corresponding authors: Rui-Qing Liu and Dong-Sheng Wang.
ISSN:1948-9366
1948-9366
DOI:10.4240/wjgs.v17.i5.102201