PP286 - INFLAMMATORY CYTOKINE PROGNOSTIC SCORE AND NUTRITION–MUSCLE PHENOTYPES IN GASTRIC ADENOCARCINOMA

PP286

INFLAMMATORY CYTOKINE PROGNOSTIC SCORE AND NUTRITION–MUSCLE PHENOTYPES IN GASTRIC ADENOCARCINOMA

C. He¹, H. Zhou¹, G. Wu¹, Z. Li¹, D. Huang^1,*, X. Shen¹, W. Sun¹

¹The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

Rationale: TNM staging describes tumour extent but does not account for the host inflammatory and nutritional status that may influence outcome after gastrectomy. We assessed whether a preoperative inflammatory cytokine prognostic score (ICPS) provides additional prognostic information and whether its combination with nutrition–muscle phenotypes improves risk stratification.

Methods: This prospective cohort enrolled 492 patients undergoing radical gastrectomy for gastric adenocarcinoma (2021-2024). ICPS (0-6) was constructed from preoperative serum IL-2, IL-4, IL-6, IL-10, TNF-α, and IFN-γ and dichotomized as low (0-1) or high (2-6). Inverse probability of treatment weighting reduced baseline imbalance. Malnutrition, sarcopenia, and cachexia were defined per GLIM, AWGS 2019, and AWGC 2023 criteria. Overall survival was estimated with weighted Cox models. A nomogram was built using random survival forest-guided variable selection and validated internally by bootstrap resampling.

Results: After weighting, high ICPS was associated with increased mortality (HR 2.00, 95% CI 1.29-3.11; P=0.002). Correlations between ICPS and nutrition-muscle indices were weak (all |r|<0.10), suggesting these measures capture different aspects of host vulnerability. Co-occurrence of high ICPS and malnutrition yielded higher mortality risk (adjusted HR 5.29, 95% CI 2.95-9.48). Adding ICPS to the base clinicopathological model improved OS discrimination at 1, 2, and 3 years (IDI 0.021, 0.032, 0.040; all P≤0.030).

Conclusion: Preoperative ICPS was associated with overall survival after radical gastrectomy and provided prognostic information not captured by nutrition-muscle phenotypes alone. Joint assessment identified a subgroup with poorer outcome. These findings require multi-centre external validation and external validation is needed before broader clinical use.

Disclosure of Interest: None declared