title: Prognostic value of preoperative neutrophils to lymphocytes ratio in patients resected for gastric cancer.
abstract: BACKGROUND
  The neutrophil/lymphocyte ratio (NLR) in the peripheral blood is considered an easily assessable prognostic factor in cancer patients. We evaluated the predictive significance of the NLR in patients affected by gastric cancer that underwent gastric resection.
  
  
  METHODS
  From July 2003 to March 2012, 156 patients who had undergone gastrectomy with curative intent for gastric adenocarcinoma were included. Data were retrieved from a prospective collected database. NLR was calculated from lymphocyte and neutrophil counts on routine blood tests taken before surgery. Survival analyses were generated according to the Kaplan-Meier method. Univariate and multivariate analyses were carried out by the Cox proportional hazard model.
  
  
  RESULTS
  The median follow-up time for surviving patients was 38 months (range 1 to 108 months) and median preoperative NLR was 2.3 (range .47 to 19.73). Subjects were dichotomized at the N/L value of 2.3. Median survival of patients with NLR below the median was around 60 months compared with the 36 months of patients with an NLR above the median. A multivariate analysis established a significant and independent relationship between the NLR and the overall survival with a P value of less than .05.
  
  
  CONCLUSIONS
  The results suggest that the elevated preoperative NLR predicts poor overall survival following resection for gastric adenocarcinoma. It may be used as a simple, reliable prognostic factor for risk stratification.
authors.affiliation: Dipartimento di Scienze Chirurgiche, Radiologiche e Odontostomatologiche, Nuova Facoltà di Medicina e Chirurgia, Sant'Andrea delle Fratte, Perugia 06132, Italy.
authors.forename: Luigina
authors.initials: L
authors.lastname: Graziosi
authors.affiliation: Dipartimento di Scienze Chirurgiche, Radiologiche e Odontostomatologiche, Nuova Facoltà di Medicina e Chirurgia, Sant'Andrea delle Fratte, Perugia 06132, Italy. Electronic address: elisabettamarino@icloud.com.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Marino
authors.affiliation: Oncologia Medica, Ospedale Santa Maria della Misericordia, Sant'Andrea delle Fratte, Perugia 06132, Italy.
authors.forename: Verena
authors.initials: V
authors.lastname: De Angelis
authors.affiliation: Dipartimento di Scienze Chirurgiche, Radiologiche e Odontostomatologiche, Nuova Facoltà di Medicina e Chirurgia, Sant'Andrea delle Fratte, Perugia 06132, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Rebonato
authors.affiliation: Dipartimento di Scienze Chirurgiche, Radiologiche e Odontostomatologiche, Nuova Facoltà di Medicina e Chirurgia, Sant'Andrea delle Fratte, Perugia 06132, Italy.
authors.forename: Emanuel
authors.initials: E
authors.lastname: Cavazzoni
authors.affiliation: Dipartimento di Scienze Chirurgiche, Radiologiche e Odontostomatologiche, Nuova Facoltà di Medicina e Chirurgia, Sant'Andrea delle Fratte, Perugia 06132, Italy.
authors.forename: Annibale
authors.initials: A
authors.lastname: Donini
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009504:Neutrophils / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Gastric cancer; Neutrophils to lymphocytes ratio