title: Prognostic Value of the Preoperative Neutrophil to Lymphocyte Ratio in Resectable Gastric Cancer.
abstract: This study aimed to investigate the prognostic value of the preoperative neutrophil to lymphocyte ratio (NLR) in resectable gastric cancer (GC). This was a retrospective review of 1030 patients with resectable GC managed between 2005 and 2011. Patients were stratified into 2 groups, those with a preoperative NLR >3.44 and those with a preoperative NLR ≤ 3.44. Clinicopathological data affecting patient prognosis were collected prospectively and analyzed. The high NLR (> 3.44) group had a higher proportion of a platelet to lymphocyte ratio > 132, tumor size > 4.8 cm, T4 lesions, metastatic tumors, a ratio of metastatic to examined lymph nodes >0.18, positive resection margins, and presence of vascular or lymphatic invasion than the low NLR (≤ 3.44) group. Patients with a high preoperative NLR had significantly lower 3- and 5-year overall survival rates than those with a low preoperative NLR (55.1% vs 71.0% and 47.2% vs 64.1%, respectively; P < 0.001). Preoperative NLR was a prognostic factor for resectable GC in multivariate analysis. More aggressive tumor behavior was observed in patients with resectable GC with a high preoperative NLR than in those with a low preoperative NLR. High preoperative NLR was an independent unfavorable prognostic factor. Measurement of this ratio may serve as a clinically accessible and useful biomarker for patient outcomes.
authors.affiliation: From the Department of Surgery (J-TH, C-KL, T-SY), Department of Gastroenterology (P-HL, T-HC, C-JL), and Department of Hematology-Oncology, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan (J-SC) and Department of Surgery, Chang Gung Memorial Hospital at Keelung, Chang Gung University College of Medicine, Taoyuan, Taiwan (K-CC).
authors.forename: Jun-Te
authors.initials: JT
authors.lastname: Hsu
authors.forename: Chun-Kai
authors.initials: CK
authors.lastname: Liao
authors.forename: Puo-Hsien
authors.initials: PH
authors.lastname: Le
authors.forename: Tsung-Hsing
authors.initials: TH
authors.lastname: Chen
authors.forename: Chun-Jung
authors.initials: CJ
authors.lastname: Lin
authors.forename: Jen-Shi
authors.initials: JS
authors.lastname: Chen
authors.forename: Kun-Chun
authors.initials: KC
authors.lastname: Chiang
authors.forename: Ta-Sen
authors.initials: TS
authors.lastname: Yeh
mesh_terms: D000368:Aged; D005260:Female; D005743:Gastrectomy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008214:Lymphocytes / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009504:Neutrophils / Q000378:metabolism*; D057234:Preoperative Period; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000601:surgery*