Data_Sheet_1_Peking Prognostic Score, Based on Preoperative Sarcopenia Status, Is a Novel Prognostic Factor in Patients With Gastric Cancer.DOCX

BackgroundThis study focused on assessing the role of the Peking prognostic score (PPS), a novel prognostic index based on muscle atrophy and lymphocyte-to-C-reactive protein ratio, within gastric cancer patient prognosis.MethodsWe analyzed the data collected from 774 gastric cancer cases between April 2011 and February 2016 (discovery cohort). The results were assessed in 575 gastric cancer cases from March 2016 to September 2019 (validation cohort). For evaluating skeletal muscle mass, we obtained computed tomography images at the third lumbar vertebra level (L3). We performed a time-dependent receiver operating characteristic curve (t-ROC) to analyze PPS’s prognostic significance with others.ResultsThe discovery cohort enrolled altogether 774 patients with non-metastatic gastric cancer, including 639 (82.5%) men along with 135 (17.5%) women. The patients were divided into 3 groups; 166 patients (21.4%) were assigned into group 0, 472 (60.9%) in group 1, and 136 (17.7%) in group 2, respectively. An increased PPS was in direct proportion to an elder age, reduced body mass index, higher Pathological Tumor Lymph Node Metastasis stage, perineural invasion, and vascular invasion. We identified PPS to independently estimate patient overall survival (OS) together with disease-free survival (DFS; both P < 0.001). Additionally, as revealed by t-ROC analysis, PPS exhibited the highest sensitivity compared with other prognostic scoring systems in predicting patient survival. Finally, we evaluated the prognostic value of PPS in the validation cohort and confirmed that preoperative PPS independently estimates patient OS and DFS.ConclusionThe PPS accounts for an efficient nutrition-inflammation prognostic scoring system in gastric cancer patients.

背景：本研究旨在评估基于肌肉萎缩和淋巴细胞与C反应蛋白比值的新型预后指数——北京预后评分（PPS）在胃癌患者预后中的作用。方法：我们分析了2011年4月至2016年2月间收集的774例胃癌病例数据（发现队列），并在2016年3月至2019年9月间对575例胃癌病例进行了结果评估（验证队列）。为了评估骨骼肌质量，我们在第三腰椎水平（L3）获取了计算机断层扫描图像。我们通过时间依赖性受试者工作特征曲线（t-ROC）分析PPS的预后意义与其他指标。结果：发现队列共纳入了774例非转移性胃癌患者，其中639例（82.5%）为男性，135例（17.5%）为女性。患者被分为三组：166例（21.4%）分配到0组，472例（60.9%）分配到1组，136例（17.7%）分配到2组。PPS值与年龄增大、体重指数降低、病理学肿瘤淋巴结转移期更高、神经侵犯和血管侵犯呈正相关。我们发现PPS可以独立估计患者的总生存期（OS）和无病生存期（DFS；两者均P < 0.001）。此外，根据t-ROC分析，与其他预后评分系统相比，PPS在预测患者生存方面表现出最高的灵敏度。最后，我们在验证队列中评估了PPS的预后价值，并证实术前PPS可以独立估计患者的OS和DFS。结论：PPS是一种高效的营养-炎症预后评分系统，适用于胃癌患者。