Abstract:

INTRODUCTION: Gastric adenocarcinoma (GC) is a common malignancy with a poor prognosis. There is a need for prognostic markers to assist treatment decisions in GC. Naples prognostic score (NPS) and controlling nutritional status (CONUT) score are immune-nutritional scores that predict outcomes in different early-stage tumours. Data on the performance of these in metastatic GC are scarce. We evaluated the relationship of CONUT and NPS with prognosis in patients with metastatic GC. METHODS: We retrospectively analysed 201 patients who received first-line platinum-based chemotherapy for metastatic GC between 2017-2021. NPS and CONUT were calculated depending on the pre-treatment laboratory. Overall survival (OS) analyses were performed regarding NPS and CONUT. RESULTS: Median survival negatively correlated with NPS and CONUT. Clinical parameters that may be associated with OS were evaluated. Liver metastases were associated with shorter survival, while peritoneal involvement did not. Tumour differentiation was not associated with OS. In the univariate analysis, the number of metastatic foci, the presence of hepatic metastases, increased Ca19-9, decreased albumin levels, extraperitoneal metastatic disease, NPS, and CONUT were associated with lower OS. Age, gender, tumour differentiation ECOG, and CEA levels did not affect survival. In multivariate analyses, lower albumin, higher Ca19-9, hepatic metastases, and NPS (OR: 2.9) were independently associated with shorter survival. CONUT did not have an effect on OS in multivariate analysis. DISCUSSION AND CONCLUSION: Among immuno-nutritional scores, CONUT and NPS, predict poor prognosis in metastatic GC patients. The NPS seems superior to the CONUT.

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