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Langenbeck's Archives of Surgery
Published in: Langenbeck's Archives of Surgery 6/2019

01-09-2019 | Gastric Cancer | Original Article

Preoperative total cholesterol-lymphocyte score as a novel immunonutritional predictor of survival in gastric cancer

Authors: Daiki Matsubara, Katsutoshi Shoda, Takeshi Kubota, Toshiyuki Kosuga, Hirotaka Konishi, Atsushi Shiozaki, Hitoshi Fujiwara, Kazuma Okamoto, Michihiro Kudou, Tomohiro Arita, Ryo Morimura, Yasutoshi Murayama, Hisashi Ikoma, Yoshiaki Kuriu, Masayoshi Nakanishi, Eigo Otsuji

Published in: Langenbeck's Archives of Surgery | Issue 6/2019

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Abstract

Purpose

Immunonutritional status is a known prognostic correlate in the context of gastric cancer (GC). In the present study, we investigated the prognostic relevance of a lipid profile-based immunonutritional score in patients with GC.

Methods

Data pertaining to 224 patients with stage II and III GC who underwent curative gastrectomy were retrospectively analyzed. The total cholesterol-lymphocyte score (TL score) was defined as follows: patients with both low total cholesterol (TC) and total lymphocyte count were allocated a score of 2; patients with only one or none of these biochemical abnormalities were allocated a score of 1 or 0, respectively.

Results

Among the serum lipid indices, low TC was the strongest predictor of cancer-specific survival (CSS; p = 0.001). On multivariate analysis, both low prognostic nutritional index (PNI) (p < 0.001) and high TL score (p = 0.003) were independent prognostic factors. PNI was significantly associated with peritoneal recurrence (p = 0.047), while TL score was significantly associated with locoregional and distant metastasis (p = 0.004 and p = 0.003, respectively).

Conclusions

TL score may facilitate risk stratification of patients based on CSS. TL score plus PNI may help predict the recurrence pattern in patients with stage II and III GC.
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Metadata
Title
Preoperative total cholesterol-lymphocyte score as a novel immunonutritional predictor of survival in gastric cancer
Authors
Daiki Matsubara
Katsutoshi Shoda
Takeshi Kubota
Toshiyuki Kosuga
Hirotaka Konishi
Atsushi Shiozaki
Hitoshi Fujiwara
Kazuma Okamoto
Michihiro Kudou
Tomohiro Arita
Ryo Morimura
Yasutoshi Murayama
Hisashi Ikoma
Yoshiaki Kuriu
Masayoshi Nakanishi
Eigo Otsuji
Publication date
01-09-2019
Publisher
Springer Berlin Heidelberg
Published in
Langenbeck's Archives of Surgery / Issue 6/2019
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-019-01824-8

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