The clinical influence of the preoperative lymphocyte‐to‐monocyte ratio on the postoperative outcome of patients with early‐stage gastrointestinal cancer

Abstract

Aim: The lymphocyte-to-monocyte ratio (LMR) is useful for predicting the prognosis of patients with gastric cancer (GC) and those with colorectal cancer (CRC) undergoing surgery. The relationship between the LMR and postoperative outcome of patients with early-stage gastrointestinal cancers such as stage I GC and CRC remains unclear. Methods: We retrospectively evaluated 323 stage I GC and 152 stage I CRC patients undergoing surgery. Univariate and multivariate analyses using the Cox proportional hazards model were performed to identify the clinical characteristics associated with overall survival (OS), and the cutoff values of these variables were determined by receiver operating characteristic analysis. The Kaplan-Meier method and log-rank test were used for postoperative survival comparisons according to the LMR (GC: LMR < 4.2 vs ≥4.2; CRC: LMR < 3.0 vs ≥3.0). Results: Univariate and multivariate analyses revealed that OS was significantly associated with the LMR (<4.2/≥4.2) (HR, 2.489; 95% CI, 1.317-4.702; P = 0.005), as well as age (>75/≤75 years) (HR, 3.511; 95% CI, 1.881-6.551; P < 0.001) and albumin level (≤3.5/>3.5 g/dL) (HR, 3.040; 95% CI, 1.575-5.869; P = 0.001), in stage I GC patients. Survival analysis demonstrated a significantly poorer OS in stage I GC patients with a LMR < 4.2 compared with ≥4.2 (P < 0.001). In stage I CRC patients, despite a significant difference in OS according to the LMR (<3.0 vs ≥3.0) (P = 0.040), univariate analysis revealed no significant association between the LMR and OS. Conclusion: LMR is a useful predictor of the postoperative outcome of stage I GC patients treated surgically. K E Y W O R D S immunosuppression, lymphocyte-to-monocyte ratio, stage I colorectal cancer, stage I gastric cancer This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Lymphocyte-to-Monocyte Ratio Is a Predictive Biomarker of Response to Treatment with Nivolumab for Gastric Cancer

“…We found that the 2wLMR was useful in predicting treatment response and prognosis in patients with unresectable and recurrent gastric cancer who received nivolumab monotherapy, thereby suggesting that it could be an early surrogate marker of favorable outcomes in patients with gastric cancer receiving nivolumab monotherapy. In previous studies, patients with a low LMR were found to have a poor prognosis in gastric [11,12,20,21], colorectal [11,22], lung [23], and breast [24] cancers.…”

“…It is clear that nivolumab monotherapy affects systemic immunity as it causes a variety of immune-related adverse events (irAEs) [6]. Systemic inflammation-related variables reportedly affect the prognosis of many malignancies, including gastric cancer [10][11][12]. Therefore, we hypothesized that these variables could be used to predict response to nivolumab monotherapy for gastric cancer and help assess the prognosis.…”

Efficacies of anlotinib monotherapy versus gemcitabine-based chemotherapy for patients with advanced soft tissue sarcoma after the failure of anthracycline-based chemotherapy

“…In addition, platelets, neutrophils, lymphocytes, and monocytes of blood samples were recorded before the first administration. Based on previous research findings, the critical thresholds have been set as follows: absolute lymphocyte count (ALC) (cells/mm 3 ) at 1500 (Shimizu et al 2020 ), absolute neutrophil count (ANC) (cells/mm 3 ) at 4000 (Cojocaru et al 2022 ), neutrophil-to-lymphocyte ratio (NLR) at 3.5 (de Juan Ferré et al 2021 ), platelet-to-lymphocyte ratio (PLR) at 200 (von Mehren et al 2020 ), and lymphocyte-to-monocyte ratio (LMR) at 3.0 (Smrke et al 2020 ).…”

Does the Use of Peripheral Immune-Related Markers Indicate Whether to Administer Pazopanib, Trabectedin, or Eribulin to Advanced Soft Tissue Sarcoma Patients?

“…ALC, NLR, PLR, and LMR were calculated from blood samples collected within a week before administration of the first drug. The cutoff values were set as follows: 1500 for ALC, 3 for NLR, 200 for PLR, and 3 for LMR based on previous studies [17][18][19]. The following patient demographics were obtained from medical records: age, sex, location of the primary tumor, surgical resection of the primary tumor, histological diagnosis, Eastern Cooperative Oncology Group performance status (ECOG PS) at the start of drug administration, number of previous chemotherapies, previous administration of doxorubicin or ifosfamide, number of following chemotherapies, and history of radiotherapy or carbonion radiotherapy.…”