title: Absolute monocyte and lymphocyte count prognostic score for patients with gastric cancer.
abstract: OBJECTIVE
  To measure the prognostic significance of absolute monocyte count/absolute lymphocyte count prognostic score (AMLPS) in patients with gastric cancer.
  
  
  METHODS
  We retrospectively examined the combination of absolute monocyte count (AMC) and absolute lymphocyte count (ALC) as prognostic variables in a cohort of 299 gastric cancer patients who underwent surgical resection between 2006 and 2013 and were followed at a single institution. Both AMC and ALC were dichotomized into two groups using cut-off points determined by receiving operator characteristic curve analysis. An AMLPS was generated, which stratified patients into three risk groups: low risk (both low AMC and high ALC), intermediate risk (either high AMC or low ALC), and high risk (both high AMC and low ALC). The primary objective of the study was to validate the impact of AMLPS on both disease-free survival (DFS) and overall survival (OS), and the second objective was to assess the AMLPS as an independent prognostic factor for survival in comparison with known prognostic factors.
  
  
  RESULTS
  Using data from the entire cohort, the most discriminative cut-off values of AMC and ALC selected on the receiver operating characteristic curve were 672.4/μL and 1734/μL for DFS and OS. AMLPS risk groups included 158 (52.8%) patients in the low-risk, 128 (42.8%) in the intermediate-risk, and 13 (4.3%) in the high-risk group. With a median follow-up of 37.2 mo (range: 1.7-91.4 mo), five-year DFS rates in the low-, intermediate-, and high-risk groups were 83.4%, 78.7%, and 19.8%, respectively. And five-year OS rates in the low-, intermediate-, and high-risk groups were 89.3%, 81.1%, and 14.4%, respectively. On multivariate analysis performed with patient- and tumor-related factors, we identified AMLPS, age, and pathologic tumor-node-metastasis stage as the most valuable prognostic factors impacting DFS and OS.
  
  
  CONCLUSIONS
  AMLPS identified patients with a poor DFS and OS, and it was independent of age, pathologic stage, and various inflammatory markers.
authors.affiliation: Wan Kyu Eo, Da Wun Jeong, Hye Jung Chang, Department of Hematology/Medical Oncology, Kyung Hee University Hospital at Gangdong, Seoul 134727, South Korea.
authors.forename: Wan Kyu
authors.initials: WK
authors.lastname: Eo
authors.affiliation: Wan Kyu Eo, Da Wun Jeong, Hye Jung Chang, Department of Hematology/Medical Oncology, Kyung Hee University Hospital at Gangdong, Seoul 134727, South Korea.
authors.forename: Da Wun
authors.initials: DW
authors.lastname: Jeong
authors.affiliation: Wan Kyu Eo, Da Wun Jeong, Hye Jung Chang, Department of Hematology/Medical Oncology, Kyung Hee University Hospital at Gangdong, Seoul 134727, South Korea.
authors.forename: Hye Jung
authors.initials: HJ
authors.lastname: Chang
authors.affiliation: Wan Kyu Eo, Da Wun Jeong, Hye Jung Chang, Department of Hematology/Medical Oncology, Kyung Hee University Hospital at Gangdong, Seoul 134727, South Korea.
authors.forename: Kyu Yeoun
authors.initials: KY
authors.lastname: Won
authors.affiliation: Wan Kyu Eo, Da Wun Jeong, Hye Jung Chang, Department of Hematology/Medical Oncology, Kyung Hee University Hospital at Gangdong, Seoul 134727, South Korea.
authors.forename: Sung Il
authors.initials: SI
authors.lastname: Choi
authors.affiliation: Wan Kyu Eo, Da Wun Jeong, Hye Jung Chang, Department of Hematology/Medical Oncology, Kyung Hee University Hospital at Gangdong, Seoul 134727, South Korea.
authors.forename: Se Hyun
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Wan Kyu Eo, Da Wun Jeong, Hye Jung Chang, Department of Hematology/Medical Oncology, Kyung Hee University Hospital at Gangdong, Seoul 134727, South Korea.
authors.forename: Sung Wook
authors.initials: SW
authors.lastname: Chun
authors.affiliation: Wan Kyu Eo, Da Wun Jeong, Hye Jung Chang, Department of Hematology/Medical Oncology, Kyung Hee University Hospital at Gangdong, Seoul 134727, South Korea.
authors.forename: Young Lim
authors.initials: YL
authors.lastname: Oh
authors.affiliation: Wan Kyu Eo, Da Wun Jeong, Hye Jung Chang, Department of Hematology/Medical Oncology, Kyung Hee University Hospital at Gangdong, Seoul 134727, South Korea.
authors.forename: Tae Hwa
authors.initials: TH
authors.lastname: Lee
authors.affiliation: Wan Kyu Eo, Da Wun Jeong, Hye Jung Chang, Department of Hematology/Medical Oncology, Kyung Hee University Hospital at Gangdong, Seoul 134727, South Korea.
authors.forename: Young Ok
authors.initials: YO
authors.lastname: Kim
authors.affiliation: Wan Kyu Eo, Da Wun Jeong, Hye Jung Chang, Department of Hematology/Medical Oncology, Kyung Hee University Hospital at Gangdong, Seoul 134727, South Korea.
authors.forename: Ki Hyung
authors.initials: KH
authors.lastname: Kim
authors.affiliation: Wan Kyu Eo, Da Wun Jeong, Hye Jung Chang, Department of Hematology/Medical Oncology, Kyung Hee University Hospital at Gangdong, Seoul 134727, South Korea.
authors.forename: Yong Il
authors.initials: YI
authors.lastname: Ji
authors.affiliation: Wan Kyu Eo, Da Wun Jeong, Hye Jung Chang, Department of Hematology/Medical Oncology, Kyung Hee University Hospital at Gangdong, Seoul 134727, South Korea.
authors.forename: Ari
authors.initials: A
authors.lastname: Kim
authors.affiliation: Wan Kyu Eo, Da Wun Jeong, Hye Jung Chang, Department of Hematology/Medical Oncology, Kyung Hee University Hospital at Gangdong, Seoul 134727, South Korea.
authors.forename: Heung Yeol
authors.initials: HY
authors.lastname: Kim
mesh_terms: D000230:Adenocarcinoma / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D005743:Gastrectomy; D006801:Humans; D053208:Kaplan-Meier Estimate; D007958:Leukocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D009000:Monocytes; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome
keywords: Absolute lymphocyte count; Monocytes; Stomach neoplasms