Elevated preoperative neutrophil to lymphocyte ratio predicts poor survival following resection in late stage gastric cancer.
Jung, Mi Ran MD 1; Park, Young Kyu MD 1*; Jeong, Oh MD 1; Seon, Jang Won MD 1; Ryu, Seong Yeob MD 1; Kim, Dong Yi MD 1; Kim, Young Jin MD 1
[Article] Journal of Surgical Oncology. 104(5):504-510, October 2011.

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Background: Elevated neutrophil to lymphocyte ratio (N/L ratio) has been shown to be a prognostic indicator in various cancers. We aimed to investigate the prognostic significance of the preoperative N/L ratio in late stage gastric cancer.

Methods: From April 2004 to August 2007, 293 patients who had undergone gastrectomy with curative intent for the AJCC/UICC TNM Stage III or IV gastric cancer were included. N/L ratio was calculated from lymphocyte and neutrophil counts on routine blood tests taken prior to surgery.

Results: The median follow-up time for surviving patients was 38.2 months (4.2-65.5 months) and median preoperative N/L ratio was 2.06 (range 0.47-19.73). Subjects were dichotomized at the N/L value of 2.0. A multivariate analysis established a significant relationship between the N/L ratio and overall survival (HR = 1.609; 95% confidence interval, CI, 1.144-2.264; P = 0.006). The cutoff value up to 3.0, the value of 75 percentiles, showed a significant prognostic effect on disease-free survival (HR = 1.654; 95% CI, 1.088-2.515; P = 0.019).

Conclusions: The results suggest that the elevated preoperative N/L ratio predicts poor disease-free and overall survival following resection for late stage gastric cancer. It may be utilized as a simple, reliable prognostic factor for risk stratification and will provide better treatment allocation. J. Surg. Oncol. 2011; 104:504-510. (C) 2011 Wiley-Liss, Inc.

Copyright (C) 2011 John Wiley & Sons, Inc.