Preoperative serum magnesium level as a prognostic and predictive biomarker in locally advanced gastric cancer patients receiving neoadjuvant immunochemotherapy

作者：Xiaohang Liu, Xiong Sun, Lin Yao, Chengguo Li, Qian Shen, Jianing Ding, Tianhao Li, Dai Lu, Xuanfei Li, Shijun Zhao, Kaixiong Tao, Yuping Yin · 发表于：World Journal of Surgical Oncology · 年份：2025 · DOI：10.1186/s12957-025-04084-7 · 被引用次数：2 · 研究领域：Magnesium in Health and Disease、Parathyroid Disorders and Treatments、Potassium and Related Disorders

BACKGROUND: The global multicenter phase III MATTERHORN trial further validated the scientific rationale and clinical value of our earlier research, demonstrating that the combination therapy significantly improved patient survival outcomes and provided critical evidence for optimizing gastric cancer treatment strategies worldwide. Nevertheless, despite the overall effectiveness of neoadjuvant immunochemotherapy (NICT), approximately half of the patients did not achieve optimal therapeutic responses. Moreover, only a few clinically useful biomarkers can predict the treatment outcomes. The relationship between pre-treatment serum electrolyte levels and treatment outcomes in patients with locally advanced gastric cancer (LAGC) after NICT remains unclear. METHODS: A retrospective analysis was conducted on clinical data from 112 patients with LAGC who underwent radical surgery after NICT between 2020 and 2024. Serum electrolyte levels were measured prior to NICT. The associations between serum electrolyte levels and overall survival (OS) and disease-free survival (DFS) were evaluated. RESULTS: In the Kaplan-Meier survival analysis of pre-treatment serum electrolytes, only sodium showed a significant association; however, it was not an independent prognostic factor, according to the Cox regression analysis. Low pre-treatment serum magnesium levels were significantly associated with poorer OS (HR = 21.48, P < 0.001) and DFS (HR = 8.730, P < 0.001). Multivariate Cox regression analy...