Monocyte-to-lymphocyte ratio as a determinant of survival in patients with gastric cancer undergoing gastrectomy: A cohort study

Abstract

The monocyte-to-lymphocyte ratio (MLR) is an important prognostic determinant of various malignancies. However, the prognostic role of MLR in patients with gastric cancer undergoing gastrectomy remains unclear. Patients with stage I to III gastric cancer who underwent curative-intent gastric resection were enrolled in this study. Cox regression analysis was used to determine the independent variables for overall survival (OS) and disease-free survival (DFS). The established models were validated internally. Inter-model comparisons were performed using the integrated area under the receiver operating characteristic curve and the concordance index. Multivariate Cox regression analysis revealed that age, tumor-node-metastasis (TNM) stage, perineural invasion, serum albumin level, and MLR were prognostic factors for OS and DFS and constituted the full model. The full model was internally validated using calibration curves and decision curve analysis. The integrated area under the curve and concordance index of the full model outperformed those of TNM stage. The full model was a significant determinant of OS and DFS. Additionally, the full model was suggested to outperform TNM stage in predicting patient survival outcomes.Abbreviations: ALB = serum albumin level, ALC = absolute lymphocyte count, AMC = absolute monocyte count, AUC = area under the curve, C-index = concordance index, DCA = decision curve analysis, DFS = disease-free survival, GC = gastric cancer, HR = hazard ratio, iAUC = integrated AUC, MLR = monocyte-to-lymphocyte ratio, NLR = neutrophil-to-lymphocyte ratio, OS = overall survival, PLR = platelet-to-lymphocyte ratio, PNI = perineural invasion, ROC = receiver operating characteristic, TNM = tumor-node-metastasis, VIF = variance inflation factor.

Prognostic analysis of stage IIIC1p cervical cancer patients

“…This reflects a state of enhanced inflammation and reduced immunity, which favors tumor progression. Studies have shown that MLR is a valuable marker for the diagnosis and prognosis of various cancers including colorectal ( 22 ), breast ( 23 ), and gastric ( 24 ) cancers. According to our research, the MLR serves as a separate predictive element for individuals diagnosed with stage IIIC1p cervical cancer, and a higher preoperative MLR value corresponds to a poorer prognosis.…”