Cancer Management and Research (May 2021)

A Nomogram Model Involving Preoperative Fibrinogen and Prognostic Nutritional Index Score for Predicting Postoperative Outcome in Patients with Gastric Cancer

  • Wang P,
  • Wang H,
  • Qiu G,
  • Liu J,
  • Fan L,
  • Liao X,
  • Che X

Journal volume & issue
Vol. Volume 13
pp. 4191 – 4201

Abstract

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Panxing Wang, Haijiang Wang, Guanglin Qiu, Jiahuang Liu, Lin Fan, Xinhua Liao, Xiangming Che Department of General Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shanxi Province, People’s Republic of ChinaCorrespondence: Xiangming CheDepartment of General Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, 277 Yanta West Road, Xi’an, Shanxi Province, 710061, People’s Republic of ChinaTel +86-18991232115Fax +86-298-532-3284Email [email protected]: Inflammation and nutrition play vital roles in the development of gastric cancer (GC). We combined the preoperative fibrinogen with prognostic nutritional index (PNI) to create a novel scoring system named as the fibrinogen and prognostic nutritional index (FPNI) score and establish a more effective model.Patients and Methods: A total of 689 patients with gastric adenocarcinoma who underwent gastrectomy from January 2012 to December 2016 were reviewed. We measured correlations between FPNI score and clinicopathological variables and overall survival (OS). A nomogram predicting OS was constructed. Its predictive performance was verified using the concordance index, calibration curves, receiver operating characteristic curves, decision curve analysis and time-dependent receiver operating characteristic analysis.Results: We observed that the FPNI score was an independent predictor of OS in patients with gastric cancer (P < 0.05). A high FPNI score was significantly related to older age at surgery, tumor size ≥ 4.6 cm, high ASA score, advanced TNM stage and poor outcome (both P < 0.05). And the FPNI score remained an independent indicator at various TNM stages (P < 0.05). Ultimately, the nomogram based on FPNI score, age, tumor size, histological grade and TNM stage showed a better predictive ability than TNM alone.Conclusion: The preoperative FPNI score is a novel, simple, and effective predictor of OS in patients with GC. Furthermore, the nomogram involving FPNI score will help clinicians to optimize individualized treatment plans.Keywords: gastric cancer, fibrinogen, prognostic nutritional index, overall survival, nomogram

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