The predictive value of systemic nutritional and inflammatory biomarkers in patients with advanced gastrointestinal stromal tumor treated with imatinib

Abstract

Abstract Background Systemic nutritional and inflammatory biomarkers have been shown to be prognostic for many types of cancer. However, there are limited data on their predictive significance in advanced stage gastrointestinal stromal tumors (GISTs). Methods We retrospectively analyzed data of 71 patients with advanced GIST treated with first-line imatinib. A receiver operating characteristic (ROC) curve analysis was used to determine the optimal cut-off value of nutritional and inflammatory parameters, including albumin-to-globulin ratio (AGR), prognostic-nutritional-index (PNI), systemic-immune-inflammation-index (SII), HALP (haemoglobin-albumin-lymphocyte-platelet), neutrophil/lymphocyte ratio (NLR), and haemoglobin for progression free survival (PFS). Kaplan-Meier curve was used to assess the predictive value of clinical and laboratory parameters, followed by multivariable analysis with cox-regression analysis. Results Median PFS was 26.0 (16.1–35.8) months. While age, gender, stage, metastatic site, number of metastases were not effective on PFS, HALP, PNI, haemoglobin, AGR and SII were predictive. In multivariate analysis, AGR (HR 95%CI: 2.01, 1.04–3.90, p value: 0.039) and Hgb (HR 95%CI: 2.22, 1.19–4.13, P: 0.012) remained independent predictive parameters for PFS. Age, HALP, Heamoglobin, and AGR were independent prognostic biomarkers for overall survival. Conclusion The predictive value of AGR and Hgb levels is more prominent in advanced stage GISTs than inflammatory parameters.