Impact of Nutrition Risk Index, Prognostic Nutritional Index and Skeletal Muscle Index on Early Myelosuppression of First-line Chemotherapy in Stage IV Gastric Cancer Patients

Overview

Journal BMC Gastroenterol

Publisher Biomed Central

Specialty Gastroenterology

Date 2024 Dec 19

PMID 39695992

Authors

Juan Wei

WeiFeng Xiang

Hangping Wei

Xiaoyan Hu

Yifang Lu

Xiaofang Dong

Affiliations

Soon will be listed here.

Abstract

Background: In gastric cancer (GC) patients, malnutrition is common and has a negative impact on treatment tolerance, survival, and prognosis. The purpose of this study was to explore the relationship between prechemotherapy nutritional state and early myelosuppression in stage IV GC patients treated with first-line chemotherapy.

Methods: This retrospective study included patients with stage IV GC who received first-line chemotherapy between July 2012 and December 2021. Clinical and laboratory data were collected within 1 week before chemotherapy to calculate nutrition risk index, prognostic nutritional index. Pretreatment abdominal computed tomography scans were used to quantify skeletal muscle index (SMI). The main measurable outcome was the incidence of grade ≥ 2 early myelosuppression after chemotherapy.

Results: Among 102 patients eligible for analysis, 50% were malnourished, 50% were poor prognoses and 49% were sarcopenic at baseline.The side effects were generally well managed, with a 26.5% occurrence of grade 3/4 side effects. Pre-chemotherapy patients with low Nutrition Risk Index (NRI) (p = 0.002), low prognostic nutritional index (PNI) (p = 0.001), and low SMI (p = 0.001) had significantly higher incidences of grade ≥ 2 myelosuppression occurred after the first cycle of chemotherapy. Moreover, the high level of PNI was associated with higher completion rate of chemotherapy (p = 0.01). Multivariate logistic regression analysis revealed that SMI at baseline (p = 0.006) and hemoglobin level (p = < 0.001) were prognostic factors for grade ≥ 2 early myelosuppression.

Conclusion: Stage IV GC patients with low NRI, low PNI and low SMI experienced significantly more grade ≥ 2 early myelosuppression during the first line of chemotherapy.

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