ArticleDiscover oncology2026
A novel composite score based on NLR, PLR, and PNI for constructing a nomogram to predict overall survival in patients with gastric cancer.
Article in Discover oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThis study aimed to develop an NPPs composite score integrating the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and prognostic nutritional index (PNI) as a comprehensive measure of host nutritional status and immune-inflammatory response. The association between the NPPs composite score and survival outcomes in patients with gastric cancer was further evaluated using a prognostic nomogram. METHODOLOGY: A total of 206 patients who underwent radical gastrectomy for gastric cancer between May 2019 and April 2021 were retrospectively enrolled and followed after surgery. The median follow-up time was 36 months. Overall survival (OS), defined as the interval from surgery to death or last follow-up, was the primary endpoint. All candidate predictors used to construct the prognostic model were collected preoperatively. Survival probabilities were assessed using the Kaplan-Meier method, and univariable and multivariable Cox proportional hazards regression analyses were performed based on survival time and survival status to identify independent prognostic factors. A nomogram for predicting OS was then developed and internally evaluated using bootstrap resampling, the concordance index (C-index), calibration curves, and decision curve analysis. Time-dependent ROC analyses were also performed to assess prognostic discrimination at predefined time points.
resultsKaplan-Meier analysis revealed that patients with a high NPPs composite score had significantly worse overall survival (log-rank P < 0.001). Multivariable Cox regression analysis identified age (hazard ratio [HR] > 1, P < 0.001), vascular invasion (HR > 1, P = 0.016), and NPPs composite score (HR > 1, P < 0.001) as independent factors associated with OS. Furthermore, the nomogram demonstrated excellent discrimination (C-index = 0.858, 95% CI 0.828-0.889) and exhibited favorable clinical utility based on decision curve analysis.
conclusionThe NPPs composite score was independently associated with OS in patients with gastric cancer after radical surgery. The nomogram based on survival-time analysis may be useful for individualized postoperative prognostic assessment; however, its clinical applicability should be interpreted cautiously until further external validation is performed.
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