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. 2023 Sep 11;15(18):4512.
doi: 10.3390/cancers15184512.

The Prognostic Value of the Novel Global Immune-Nutrition-Inflammation Index (GINI) in Stage IIIC Non-Small Cell Lung Cancer Patients Treated with Concurrent Chemoradiotherapy

Erkan Topkan  1 , Ugur Selek  2 , Berrin Pehlivan  3 , Ahmet Kucuk  4 , Duriye Ozturk  5 , Beyza Sirin Ozdemir  6 , Ali Ayberk Besen  7 , Huseyin Mertsoylu  8
Affiliations

The Prognostic Value of the Novel Global Immune-Nutrition-Inflammation Index (GINI) in Stage IIIC Non-Small Cell Lung Cancer Patients Treated with Concurrent Chemoradiotherapy

Erkan Topkan et al. Cancers (Basel). .

Abstract

Background: We sought to determine the prognostic value of the newly developed Global Immune-Nutrition-Inflammation Index (GINI) in patients with stage IIIC non-small cell lung cancer (NSCLC) who underwent definitive concurrent chemoradiotherapy (CCRT).

Methods: This study was conducted on a cohort of 802 newly diagnosed stage IIIC NSCLC patients who underwent CCRT. The novel GINI created first here was defined as follows: GINI = [C-reactive protein × Platelets × Monocytes × Neutrophils] ÷ [Albumin × Lymphocytes]. The receiver operating characteristic (ROC) curve analysis was used to determine the optimal pre-CCRT GINI cut-off value that substantially interacts with the locoregional progression-free (LRPFS), progression-free (PFS), and overall survival (OS).

Results: The optimal pre-CCRT GINI cutoff was 1562 (AUC: 76.1%; sensitivity: 72.4%; specificity: 68.2%; Youden index: 0.406). Patients presenting with a GINI ≥ 1562 had substantially shorter median LRPFS (13.3 vs. 18.4 months; p < 0.001), PFS (10.2 vs. 14.3 months; p < 0.001), and OS (19.1 vs. 37.8 months; p < 0.001) durations than those with a GINI < 1562. Results of the multivariate analysis revealed that the pre-CCRT GINI ≥ 1562 (vs. <1562), T4 tumor (vs. T3), and receiving only 1 cycle of concurrent chemotherapy (vs. 2-3 cycles) were the factors independently associated with poorer LRPS (p < 0.05 for each), PFS (p < 0.05 for each), and OS (p < 0.05 for each).

Conclusion: The newly developed GINI index efficiently divided the stage IIIC NSCLSC patients into two subgroups with substantially different median and long-term survival outcomes.

Keywords: Global Immune-Nutrition-Inflammation Index; biological marker; chemoradiotherapy; non-small cell lung cancer; prognosis; survival.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Receiver operating characteristic curve analysis results depicting the association between the pretreatment Global Immune-Nutrition-Inflammation Index values and survival outcomes: (A) Locoregional progression-free survival, (B) Progression-free survival, and (C) Overall survival.
Figure 2
Figure 2
Survival outcomes per Global Immune-Nutrition-Inflammation Index (GINI) groups (Dark blue: GINI < 1562; Red: GINI ≥ 1562): (A) Locoregional progression-free survival, (B) Progression-free survival, and (C) Overall survival.
See this image and copyright information in PMC

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