High preoperative neutrophil-lymphocyte ratio predicts poor survival in patients with gastric cancer

Abstract

Background. The neutrophil-lymphocyte ratio (NLR) refl ects infl ammatory status. An elevated NLR has been reported to be a prognostic indicator in some malignant tumors. The aim of this study was to evaluate the clinical signifi cance of the preoperative NLR in patients with primary gastric cancer. Results. The 5-year survival of patients with a high NLR was signifi cantly worse than that of patients with a low NLR (57% vs 82%, P < 0.001). Univariate and multivariate analyses of clinicopathological factors affecting survival revealed that high NLR, depth of tumor, positive lymph nodes, distant metastasis, peritoneal metastasis, poorly differentiated type, and high platelet count were signifi cant risk factors for reduced survival. On multivariate analysis, after adjusting for tumor stage, a high NLR was an independent risk factor for reduced survival (P = 0.003; adjusted hazard ratio, 1.845; 95% confidence interval, 1.236-2.747). Conclusion. A high preoperative NLR may be a convenient biomarker to identify patients with a poor prognosis after resection for primary gastric cancer.

Pre-treatment neutrophil to lymphocyte ratio as a prognostic marker to predict chemotherapeutic response and survival outcomes in metastatic advanced gastric cancer

“…In addition, NLR showed a significant relationship with both PFS and OS in multivariate analysis. Similar to our findings, previous studies also showed that high baseline NLR predicts poor survival in patients with operable gastric cancer [10,11,16]. These studies indicated that NLR could be a simple and reliable prognostic factor for risk stratification and might provide better treatment allocation in gastric cancer.…”

“…Although several studies have shown a relationship between NLR and stomach cancer prognosis [10,11,15,16], previous studies have mainly focused on postoperative survival in operable AGC patients rather than metastatic AGC patients. Furthermore, there are no reports on the relationship between NLR and therapeutic response in gastric cancer, even though prediction of chemotherapeutic response in metastatic AGC patients is clinically important.…”

“…However, only limited data on the clinical and prognostic significance of NLR in patients with gastric cancer have been reported [8][9][10][11], and most of the previous studies focused on NLR as a prognostic factor in operable early-stage AGC patients with limited data in metastatic AGC patients [9,11]. Furthermore, there are no reports on the relationship between NLR and chemotherapeutic response in metastatic gastric cancer.…”

A Clinical Study of the Prognostic Factors for Postoperative Early Recurrence in Patients who Underwent Complete Resection for Pulmonary Adenocarcinoma

“…The preoperative NLR reflects inflammation status, and increases number of neutrophils and/or decreased number of lymphocytes may suppress lymphokine-activated killer cells, thereby increasing the propensity of metastasis. 11) Although the prognostic significance of the preoperative NLR was not found in patients with pulmonary adenocarcinoma, further examination should be followed.…”

Elevated Circulating CD19+Lymphocytes Predict Survival Advantage in Patients with Gastric Cancer

“…Even patients who present in the most favorable condition and who undergo curative surgical resection often die of recurrent disease (Duncavage et al, 2010;Dozois et al, 2011). Although preoperative tumor staging is useful to select the appropriate therapeutic strategy for GC patients, clinical tumor staging alone cannot predict patients' prognosis (Shimada et al, 2010;Cao et al, 2011;Feng et al, 2011). It has been reported that some immune-related biomarkers for diagnosis/prognosis and therapy monitoring of GC patients (Aburatani 2005;Tan et al, 2009).…”