Prognostic Value of Nutritional Status and Early Tumor Marker Dynamics in Metastatic Gastric Cancer
Tuba Baydaş1, İlker Nihat Ökten1, Samet Ada1, Sinan Koca11Department of Medical Oncology, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul, Türkiye
Objectives: Prognostic assessment in metastatic gastric cancer remains challenging because survival is influenced by both tumor biology and host-related clinical condition. This study evaluated the prognostic value of baseline prognostic nutritional index (PNI), early CA19-9 dynamics, and a simple composite score for overall survival stratification. Methods: This retrospective cohort study included patients with histologically confirmed metastatic gastric adenocarcinoma treated at a single tertiary oncology center. Baseline clinicopathological, laboratory, treatment, and survival data were collected from institutional records. PNI was calculated from serum albumin and peripheral lymphocyte count. Early CA19-9 change was defined as the percentage change between baseline and early follow-up values. Landmark- restricted analyses were used for tumor marker kinetics. A composite score was constructed using two adverse factors: low baseline PNI and insufficient CA19-9 decline. Overall survival was analyzed using Kaplan–Meier and Cox regression models. Results: Among 126 patients, 95 had available data for both baseline PNI and early CA19-9 kinetics. High-risk patients had shorter median overall survival than low/intermediate-risk patients: 8 versus 14 months, respectively (log-rank p=0.028). In multivariable analysis, a high composite score remained independently associated with inferior overall survival (adjusted HR: 3.05, 95% CI: 1.66–5.62; p<0.001). Conclusion: A composite score integrating baseline PNI and early CA19-9 dynamics may provide clinically useful survival stratification in metastatic gastric cancer. Keywords: CA19-9, composite prognostic score, metastatic gastric cancer; overall survival, prognostic nutritional index, tumor marker kinetics
Cite This Article
Baydaş T, Ökten İ, Ada S, Koca S. Prognostic Value of Nutritional Status and Early Tumor Marker Dynamics in Metastatic Gastric Cancer. EJMI. 2026; 10(3): 284-295
Corresponding Author: Tuba Baydaş