title: The preoperative lymphocyte to monocyte ratio predicts clinical outcomes in patients with stage II/III gastric cancer.
abstract: Recently, lymphocyte to monocyte ratio (LMR) has been reported to be associated with clinical outcomes in some types of cancer but has not been explored in gastric cancer. In this study, we analyzed the association between LMR and clinical outcomes in stage II/III gastric cancer patients. Preoperative LMR calculated from peripheral lymphocyte and monocyte with corresponding clinical features from 426 stage II/III gastric cancer patients was noted. Kaplan-Meier method and Cox regression model were applied for overall survival (OS) and recurrence-free survival (RFS). Related with smaller tumor size (p<0.001), increased LMR could predict better OS [hazard ratio (HR), 0.688; 95% confidence interval (CI), 0.521-0.908, p=0.008] and was borderline significantly associated with better RFS (HR, 0.775; 95% CI, 0.592-1.01, p=0.06) in stage II/III gastric cancer patients through multivariable analysis. Subgroup analyses revealed that except stage III patients for RFS which yielded borderline significance (p=0.052), lower LMR was associated with poor clinical outcomes for patients regardless of different stages or whether the patients received adjuvant chemotherapy. The elevated preoperative LMR level was a significant favorable factor in the prognosis of stage II/III gastric cancer patients, especially for those with stage II. However, further validation of our findings is warranted.
authors.affiliation: Department of Oncology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhou
authors.forename: Yiping
authors.initials: Y
authors.lastname: Du
authors.forename: Jun
authors.initials: J
authors.lastname: Xu
authors.forename: Zebo
authors.initials: Z
authors.lastname: Huang
authors.forename: Tianzhu
authors.initials: T
authors.lastname: Qiu
authors.forename: Xiaping
authors.initials: X
authors.lastname: Wang
authors.forename: Jiaqi
authors.initials: J
authors.lastname: Qian
authors.forename: Wei
authors.initials: W
authors.lastname: Zhu
authors.forename: Ping
authors.initials: P
authors.lastname: Liu
mesh_terms: D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000473:pathology*; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D009367:Neoplasm Staging; D011300:Preoperative Care; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D015996:Survival Rate