The Sodium/D-Dimer Ratio Predicts The Effect Of First-Line Chemotherapy And Prognosis In Patients With Advanced Gastric Cancer

Background: Gastric cancer (GC) is one of the most common cancers worldwide. The survival time of patients with advanced gastric cancer (AGC) is shortened. We evaluated the role of the sodium/fibrinogen ratio (SFR) and sodium/D-dimer ratio (SDR) in predicting the first-line chemotherapy response, progression-free survival (PFS), and overall survival (OS) of patients with AGC. Methods: A total of 304 patients with AGC were retrospectively reviewed. SDR only was selected as a potential prognostic marker for the subsequent studies in this study. Based on the cut-off value of the SDR, the patients were divided into high-SDR and low-SDR groups and investigated for their clinicopathological features, first-line chemotherapy effects and clinical outcomes. Results: The cut-off value based on the SDR was 282.22, and the patients were divided into low-SDR (SDR 282.22) and high-SDR (SDR 282.22) groups. The disease control rate was higher in the high-SDR group than in the low-SDR group (91.1% vs. 82.3%; P = 0.036). Patients with a high SDR had a longer median PFS and OS than those with a low SDR (PFS: 206.0 vs. 134.0 days, P < 0.001; OS: 435.0 vs. 295.5 days, P < 0.001). The SDR was an independent prognostic indicator in the multivariable analysis of PFS (P < 0.001) and OS (P = 0.004). In subgroup analyses, among the patients with normal sodium and D-dimer levels, SDR was still a reliable prognostic indicator of PFS and OS in patients with AGC (all P < 0.001). Conclusions: This study suggests that the SDR may serve as a prognostic indicator for chemotherapy outcome, PFS and OS for patients with AGC receiving first-line chemotherapy.