Platelet-to-lymphocyte ratio as a predictor of 5-year prognosis in patients with gastrointestinal stromal tumors receiving imatinib

Yohana Sahara; Ibnu Purwanto; Kartika Widayati Taroeno Hariadi; Mardiah Suci Hardianti

doi:10.22146/inajbcs.v57i3.Supplement.24543

Yohana Sahara
Ibnu Purwanto Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl. Farmako, Yogyakarta, Indonesia
Kartika Widayati Taroeno Hariadi Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl. Farmako, Yogyakarta, Indonesia
Mardiah Suci Hardianti Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl. Farmako, Yogyakarta, Indonesia

DOI: https://doi.org/10.22146/inajbcs.v57i3.Supplement.24543

Keywords: gastrointestinal stromal tumor, imatinib, platelet-to-lymphocyte ratio, prognosis, retrospective cohort

Abstract

Gastrointestinal stromal tumor (GIST) is a common type of gastrointestinal tumor. Imatinib therapy has become the first-line therapy in patients with GIST that cannot be resected. Meanwhile, Platelet-to-Lymphocyte Ratio (PLR) is a prognostic indicator that reflects the balance between systemic inflammation and immune response. This study was conducted to determine the potential of PLR as a predictor of the 5-year prognosis of GIST patients receiving imatinib therapy. The study used a retrospective cohort design involving 42 GIST patients
at Dr. Sardjito Hospital, Yogyakarta, from 2016-2024, and data were obtained from medical records. PLR cut-off was determined by Receiver Operating Characteristic (ROC) curve analysis, while analysis was performed using Kaplan-Meier curves, log-rank test, and univariate Cox regression. During the five-year observation period, 8 patients (19.0%) died, and 34 patients (81.0%) were alive, resulting in a five-year survival rate of 81%. The mean survival time was 48.9 months. The optimal PLR cutoff value was 263.2 (AUC = 0.614; p = 0.321). Patients
with PLR ≥263.2 had a 68.4% survival rate, which was lower than the 91.3% with PLR <263.2, but this result was not statistically significant (p = 0.06). The mean survival time in the high PLR group was 43.7 months, while the low PLR group reached 54.5 months. Univariate Cox regression analysis showed that PLR was
not significantly associated with mortality risk (HR = 3.25; p = 0.149). Although this association was not statistically significant, this finding suggests that a high PLR predisposes to a decreased five-year survival in GIST patients undergoing imatinib therapy.