title: Neutrophil count and the inflammation-based glasgow prognostic score predict survival in patients with advanced gastric cancer receiving first-line chemotherapy.
abstract: OBJECTIVE
  To explore the value of systemic inflammatory markers as independent prognostic factors and the extent these markers improve prognostic classification for patients with inoperable advanced or metastatic gastric cancer (GC) receiving palliative chemotherapy.
  
  
  METHODS
  We studied the prognostic value of systemic inflammatory factors such as circulating white blood cell count and its components as well as that combined to form inflammation-based prognostic scores (Glasgow Prognostic Score (GPS), Neutrophil-Lymphocyte Ratio (NLR), Platelet Lymphocyte Ratio (PLR), Prognostic Index (PI) and Prognostic Nutritional Index (PNI)) in 384 patients with inoperable advanced or metastatic gastric cancer (GC) receiving first-line chemotherapy. Univariate and multivariate analyses were performed to examine the impact of inflammatory markers on overall survival (OS).
  
  
  RESULTS
  Univariate analysis revealed that an elevated white blood cell, neutrophil and/or platelet count, a decreased lymphocyte count, a low serum albumin concentration, and high CRP concentration, as well as elevated NLR/PLR , GPS, PI, PNI were significant predictors of shorter OS. Multivariate analysis demonstrated that only elevated neutrophil count (HR 3.696, p=0.003) and higher GPS (HR 1.621, p=0.01) were independent predictors of poor OS.
  
  
  CONCLUSIONS
  This study demonstrated elevated pretreatment neutrophil count and high GPS to be independent predictors of shorter OS in inoperable advanced or metastatic GC patients treated with first-line chemotherapy. Upon validation of these data in independent studies, stratification of patients using these markers in future clinical trials is recommended.
authors.affiliation: Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of GI Oncology, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing, China E-mail : lin100@medmail.com.cn.
authors.forename: Qing-Qing
authors.initials: QQ
authors.lastname: Li
authors.forename: Zhi-Hao
authors.initials: ZH
authors.lastname: Lu
authors.forename: Li
authors.initials: L
authors.lastname: Yang
authors.forename: Ming
authors.initials: M
authors.lastname: Lu
authors.forename: Xiao-Tian
authors.initials: XT
authors.lastname: Zhang
authors.forename: Jian
authors.initials: J
authors.lastname: Li
authors.forename: Jun
authors.initials: J
authors.lastname: Zhou
authors.forename: Xi-Cheng
authors.initials: XC
authors.lastname: Wang
authors.forename: Ji-Fang
authors.initials: JF
authors.lastname: Gong
authors.forename: Jing
authors.initials: J
authors.lastname: Gao
authors.forename: Jie
authors.initials: J
authors.lastname: Li
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.forename: Lin
authors.initials: L
authors.lastname: Shen
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000188:drug therapy / Q000276:immunology / Q000401:mortality / Q000473:pathology; D018836:Inflammation Mediators / Q000378:metabolism*; D008113:Liver Neoplasms / Q000188:drug therapy / Q000276:immunology / Q000401:mortality / Q000556:secondary*; D008175:Lung Neoplasms / Q000188:drug therapy / Q000276:immunology / Q000401:mortality / Q000556:secondary*; D008214:Lymphocytes / Q000473:pathology; D008297:Male; D009367:Neoplasm Staging; D009504:Neutrophils / Q000473:pathology*; D010534:Peritoneal Neoplasms / Q000188:drug therapy / Q000276:immunology / Q000401:mortality / Q000556:secondary*; D011379:Prognosis; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000276:immunology / Q000401:mortality / Q000473:pathology*; D015996:Survival Rate
chemical_list: D018836:Inflammation Mediators