Prediction of Peritoneal Cancer Index and Prognosis in Peritoneal Metastasis of Gastric Cancer Using NLR-PLR-DDI Score: A Retrospective Study

Figures & data

Figure 1 Peritoneal Cancer Index (PCI) scoring system.⁷

Notes:Data from Tabrizian et al.

Table 1 Characteristics of the Low and High PCI Groups

Variable	Low PCI (n=67)	95% CI	High PCI (n=35)	95% CI	P-value
Gender					0.715
Male	37		18
Female	30		17
Age	57.1±13.2	53.9–60.3	58.7±9.9	55.1–62.0	0.547
Smoking history					0.377
Yes	25		10
No	42		25
Alcohol consumption					0.878
Yes	24		12
No	43		23
BMI	21.8±2.8	21.1–22.5	21.5±2.6	20.6–22.4	0.496
Tumor location
Upper	11		2		0.242
Middle	25		15
Lower	31		16
Differentiation
Moderate	13		3		0.500
Poor	39		18
Unknown	15		14
Hb	12.0±21.0	10.3–20.6	12.8±21.5	8.3–23,1	0.958
ALB	40.4±5.19	38.1–40.6	38.8±5.15	36.4–39.9	0.264
NLR	2.72±2.45	2.77–3.97	4.33±5.52	3.99–7.78	0.001
PLR	187.3±90.5	175.52–219.68	236.0±163.1	219.44–331.47	0.007
DDI	237.0±733.3	294.41–652.15	779.0±1212.6	797.81–1630.88	0.001
CEA	2.48±80.4	6.9–52.8	2.05±11.6	2.0–10.2	0.209
CA125	35.3±170.6	36.6–119.8	134.0±154.5	122.6–232.0	0.001
CA199	28.5±2526.6	450.9–1948.2	19.1±1846.6	−121.7–1505.3	0.356
AFP	2.19±836.1	−125.2–385.3	2.61±6.3	1.3–6.7	0.310

Table 2 Independent Predictors of High PCI

Variable	Univariate		Multivariate
	OR (95% CI)	P-value	OR (95% CI)	P-value
Gender
Male	Ref		-
Female	1.165 (0.513–2.643)	0.715	-	-
Age
<70	Ref		-
≥ 70	0.764 (0.246–2.375)	0.642	-	-
BMI	0.960 (0.830–1.122)	0.643	-	-
Differentiation
Well and moderately	Ref		Ref
Poorly	0.551 (0.295–1.030)	0.062	0.604 (0.291–1.254)	0.176
NLR	1.278 (1.048–1.558)	0.015	1.276 (1.051–1.550)	0.014
PLR	1.006 (1.002–1.010)	0.008	1.006 (1.001–1.010)	0.019
DDI	1.000 (0.998–1.002)	0.002	1.001 (1.000–1.001)	0.010
CEA	0.982 (0.959–1.006)	0.136	-	-
CA199	1.000 (1.000–1.000)	0.388	-	-
CA125	1.005 (1.001–1.008)	0.014	1.003 (1.000–1.006)	0.088
AFP	1.000 (0.997–1.002)	0.666	-	-

Abbreviations: DDI, D-dimer; NLR, neutrophil-to-lymphocyte ratio; PCI, peritoneal cancer index; PLR, platelet–lymphocyte ratio.

Figure 2 Receiver operating characteristic curves for discriminating patients with low PCI (<15) and high PCI (≥15). (A) neutrophil–lymphocyte ratio, (B) platelet–lymphocyte ratio, (C) D-dimer.

Table 3 Relationship Between PCI and the NPD Score

	NPD Score				OR	P-value
	0	1	2	3
Low PCI	30	16	18	3	33.9	0.001
High PCI	1	9	12	13

Abbreviations: NPD, NLR-PLR-DDI; PCI, peritoneal cancer index.

Figure 3 Receiver operating characteristic curves for discriminating patients with low PCI (<15) and high PCI (≥15) according to NPD score.

Table 4 Relationship Between Prognosis and the NPD Score

NPD score	Mean	SD	95% CI	P-value
0	26.887	3.044	20.92–32.85	0.027
1	23.955	4.394	15.34–32.57
2	13.417	2.595	8.33–18.50
3	12.889	2.874	7.25–18.52

Abbreviation: NPD, NLR-PLR-DDI.

Figure 4 Kaplan–Meier survival curves according to the NPD score.

Table 5 Univariate and Multivariate Analyses of Overall Survival

Variable	Univariate		Multivariate
	HR (95% CI)	P-value	HR (95% CI)	P-value
Gender
Male	Ref		Ref
Female	0.607 (0.330–1.115)	0.107	0.540 (0.289–1.009	0.053
Age
<70	Ref		Ref
≥ 70	1.326 (0.612–2.871)	0.474	-	-
BMI	0.927 (0.827–1.039)	0.192	0.937 (0.830–1.056)	0.285
Differentiation
Well and moderately	Ref		Ref
Poorly	0.819 (0.546–1.230)	0.337	0.808 (0.543–1.202)	0.294
CEA	0.996 (0.984–1.009)	0.563	-	-
CA199	1.000 (1.000–1.000)	0.473	-	-
CA125	1.000 (0.998–1.002)	0.838	-	-
AFP	0.999 (0.996–1.003)	0.787	-	-
PCI	1.051 (1.013–1.089)	0.008	1.062 (1.020–1.105)	0.003
NPD score
<2	Ref		Ref
≥ 2	2.397 (1.297–4.429)	0.005	2.322 (1.234–4.369)	0.009

Abbreviations: NPD, NLR-PLR-DDI; PCI, peritoneal cancer index.

Table 6 Characteristics of PCI Decrease <6 Group and ≥6 Group

Variable	PCI Decrease		P-value
	<6 (n=28)	≥6 (n=13)
Gender			0.025
Male	17	3
Female	11	10
Age	57.8±11.3	44.3±9.1	0.479
BMI	21.2±3.1	21.0±2.3	0.327
Tumor location			0.469
Upper	4	1
Middle	12	7
Lower	12	5
Differentiation
Moderately	5	2	0.248
Poorly	15	9
Unknown	8	2
NPD score decrease			0.002
≤0	24	5
>0	4	8
CA125 proportion	2.26±2.53	9.61±8.37	0.001

Figure 5 Flow-chart with the exclusion criteria for DSL.

Table 7 Univariate and Multivariate Analysis of PCI Decrease

Variable	Univariate		Multivariate
	OR (95% CI)	P-value	OR (95% CI)	P-value
Gender
Male	Ref		Ref
Female	5.152 (1.153–23.000)	0.032	0.733 (0.052–10.352)	0.818
Age
<70	Ref		Ref
≥ 70	0.893 (0.828–0.964)	0.004	0.895 (0.782–1.025)	0.108
BMI	0.982 (0.776–1.243)	0.879	0.937 (0.830–1.056)	0.285
Differentiation
Well and moderately	Ref		Ref
Poorly	1.458 (0.565–3.758)	0.435	-	-
CA125 proportion	1.349 (1.092–1.666)	0.005	1.293 (0.985–1.732)	0.085
Weight loss	1.130 (0.939–1.359)	0.196	1.197 (0.908–1.578)	0.201
NPD score decrease	9.6 (2.060–44.741)	0.004	10.439 (1.445–75.425)	0.020

Tabrizian P, Shrager B, Jibara G, et al. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis: outcomes from a single tertiary institution. J Gastrointest Surg. 2014;18(5):1024–1031.

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