Prognostic Value of Inflammatory Markers, CA 19-9, MELD Score, and ECOG in Stage 4 Gastric Cancer with Liver Metastases

Prognostic Value of Inflammatory Markers, CA MELD Score, and ECOG in Stage 4 Gastric Cancer with Liver Metastases Aim: This study aimed to investigate the prognostic significance of the Model for End-Stage Liver Disease (MELD) score in patients with stage 4 liver metastatic gastric cancer and to investigate whether other clinical pathological data are prognostic indicators.Methods: Stage 4 liver metastatic gastric cancer patients who were followed up retrospectively between January 2014 and November 2024 were included in the study.Demographic and clinical data of the patients were entered into the database.Survival analyses were performed using the Kaplan-Meier method and the log-rank test.Independent effects of prognostic factors were evaluated using the Cox proportional hazards regression model (Cox).Statistical significance was accepted as p<0.05.Results: One hundred and fifty patients were included in the study.The median age of the patients was 64 years, and 26.3% were female.The estimated median overall survival (mOS) was 7.9 months.The mOS was 10.5 months in the Eastern Cooperative Oncology Group (ECOG) 0-1 group compared to 3.6 months in the ECOG 2-3 group (p<0.001).According to the ideal cut-off value of carbohydrate antigen (CA) 19-9, survival was 9.7 months in the 37.1 U/mL group and 6.7 months in the >37.1 U/mL group (p=0.017).There was no difference in survival according to the determined categories of age (p=0.395),gender (p=0.670),smoking status (p=0.764),body mass index (BMI) (p=0.563),carcinoembryonic antigen (CEA) (p=0.057),neutrophil-to-lymphocyte ratio (NLR) (p=0.359),platelet-to-lymphocyte ratio (PLR) (p=0.158),monocyte-to-lymphocyte ratio (MLR) (p=0.811), and MELD score (p=0.561).In univariate Cox regression analysis, an ECOG score of 2 and above [hazard ratio (HR) 4.03; p<0.001] and a CA 19-9>37.1 U/mL (HR 1.54; p=0.018) were determined as poor prognostic factors, and BMI, NLR, PLR, MLR, MELD score, and CEA did not show prognostic significance. Conclusion:We found that CA 19-9 level and ECOG performance status are markers that can be used in determining prognosis in liver metastatic gastric cancer, and the analyzed blood values (NLR, PLR, MLR) and MELD score did not demonstrate any prognostic significance in this patient group.