The Naples prognostic score (NPS), a new inflammatory and nutritional assessment system, could independently predict disease progression and survival in patients with high- and intermediate-risk gastrointestinal stromal tumor (GIST). This is according to a new study published in the World Journal of Surgical Oncology

“The NPS might be regarded and applied as one of the most convenient and effective preoperative risk stratification tools in the future,” the authors of the study wrote. However, they warned that it should first be validated in large-scale, multicenter, prospective cohort studies.

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The NPS was established based on the concentration of albumin and total cholesterol and the ratios of neutrophil-to-lymphocyte and lymphocyte-to-monocyte. It was shown to be significant for different types of cancers including oesophageal, lung, pancreatic, colorectal, endometrial, and gastric cancers as well as osteosarcoma. However, its significance in GIST was not known.

Here, a team of researchers from China conducted a retrospective cohort study based on GIST data collected from 405 patients prospectively between March 2010 and December 2019 to assess the significance of NPS in GIST.

Researchers separated the patients into 3 groups based on their NPS scores. A serum albumin concentration of 4 mg/dL or more, a total cholesterol concentration of more than 180 mg/dL, a neutrophil-to-lymphocyte ratio of 2.96 or less, or a lymphocyte-to-monocyte ratio of more than 4.44 resulted in a score of 0. Anything outside these ranges was scored as 1. NPS was the sum of all scores. Patients who had a score of 0 were in group 0, those with a score of 3 or more were assigned to group 2, and all the others were assigned to group 1. 

The results showed that there were significant differences in progression-free survival and overall survival between the 3 groups of patients

NPS is a significant predictor of poor overall survival as well as progression-free survival and is more accurate than other hematologic prognostic systems, the researchers concluded.


Wu H, Fu M, Xie X, et al. Naples prognostic score, a novel prognostic score for patients with high- and intermediate-risk gastrointestinal stromal tumours after surgical resection. World J Surg Onc. 2022;20:63. doi:10.1186/s12957-022-02526-0