Inflammatory Markers and Prognosis in High-Risk GIST

A lack of knowledge exists in understanding the influence of inflammatory markers on the prognosis of high-risk patients with gastrointestinal stromal tumors (GISTs). To determine the link between certain factors and the prognosis of these patients, a recent multicenter analysis focused on recurrence-free survival (RFS) and overall survival (OS) as prognostic indicators.

Data were collected from 145 high-risk patients with GIST from 17 different medical centers from January 2013 to December 2019. Variables were analyzed with single-factor analysis and survival curves, while independent prognostic factors were measured using a Cox regression model.

A univariate analysis found links between RFS and age, preoperative neutrophil-to-lymphocyte ratio (NLR), preoperative platelet-to-lymphocyte ratio (PLR), preoperative systemic immune-inflammatory index (SII), preoperative prognostic nutritional index (PNI), mitotic index, and whether imatinib (IM) was taken regularly in high-risk patients with GIST (P<0.05). Each factor other than age was also significantly correlated with OS (P<0.05).

Cox regression analysis identified age, preoperative PNI, mitotic index, and postoperative IM adjuvant therapy as independent predictors of RFS (P<0.05). Additionally, preoperative PNI and postoperative IM adjuvant therapy were significantly associated with OS (P<0.05). Age negatively correlated with RFS, while early routine IM treatment post-surgery significantly lowered the risk for recurrence and mortality. A higher mitotic index was linked to poorer RFS, whereas an elevated preoperative PNI indicated a more favorable prognosis.

Factors including young age, low preoperative PNI, high mitotic index, and lack of IM treatment were linked to an unfavorable prognosis in high-risk patients with GIST. PNI can also be an additional prognostic factor and can be a valuable addition to standard clinical practice for this patient population.