Neutrophil‑to‑lymphocyte ratio before each chemotherapy line predicts clinical outcomes in patients with unresectable gastric cancer

Abstract

The neutrophil-to-lymphocyte ratio (NLR) is a well-known prognostic biomarker for patients with gastric cancer (GC). However, for patients with GC treated with palliative chemotherapy, the predictive values of NLR remain obscure. Therefore, the present study evaluated the clinical impact of NLR in patients with GC treated with a series of chemotherapies. The present study retrospectively evaluated 83 patients with unresectable GC who received a series of chemotherapies. NLR in the blood was calculated before each chemotherapy initiation (before 1st-, 2nd-and 3rd-line treatment). Of the 83 patients enrolled, 56 patients (67%) received 2nd-line chemotherapy and 34 patients (41%) received 3rd-line chemotherapy. NLR at 1st-line ranged from 0.72 to 48.9 (median NLR, 3.00). Therefore, the median NLR of 3.00 was used as a definite cut-off value throughout the present study. All patients were dichotomized into NLR-high (>3.00) and NLR-low group (<3.00) by NLR evaluated before each line of chemotherapy. The median overall survival (OS) time of the low-NLR group was better than that of the high-NLR group from 1st-line to 3rd-line treatment (1st-line: 18.

Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy for Gastric Cancer with Peritoneal Carcinomatosis: Additional Information Helps to Optimize Patient Selection before Surgery

“…In addition, among the findings of this study was the significant role played by preoperative NLR in determining outcomes after CRS-HIPEC. A previous study revealed its application in dichotomizing the patients into the high- and the low-risk groups before each chemotherapy line for GC and success in predicting post-treatment outcomes [ 24 ]. Another study constructed a prediction model constituting NLR and CA19-9 in GC patients [ 25 ].…”

“…NLR appears to be a prominent factor in survival analysis, and we believe that more aggressive and progressive disease characteristics are reflected in tumor microenvironments. As an indicative prognostic factor, high serum NLR levels represent multifaceted evaluations of cancer patients, consisting of oncologic burden, tumor invasiveness, upregulation of inflammatory cancer-associated cytokines, decline of host anti-cancer immunity, and systemic-inflammation-associated malnutritional status [ 23 , 24 , 26 ]. In short, preoperative serum NLR is known to be associated not only with tumor characteristics, but also with patient attributes, including nutritional, functional, and immunological aspects [ 27 , 28 , 29 ].…”