title: A Novel Scoring System Based on Fibrinogen and the Neutrophil-Lymphocyte Ratio as a Predictor of Chemotherapy Response and Prognosis in Patients with Advanced Gastric Cancer.
abstract: OBJECTIVE
  We assessed the clinical applicability of the F-NLR score, which is based on fibrinogen (F) and the neutrophil-lymphocyte ratio (NLR), and the Glasgow Prognostic Score (GPS) to predict the therapeutic effects of chemotherapy or chemoradiotherapy on advanced gastric cancer and the prognoses of patients.
  
  
  METHODS
  Sixty-eight patients with advanced gastric cancer treated with first-line chemotherapy or chemoradiotherapy were classified into two groups based on tumor response. Furthermore, we categorized patients according to cutoff F-NLR scores of 2 [hyperfibrinogenemia (>400 mg/dl) and high NLR (>3.0)], 1 [one of these hematological abnormalities], and 0 [neither hyperfibrinogenemia nor high NLR].
  
  
  RESULTS
  A total of 27 patients had progressive disease (PD) and 41 did not. The F-NLR scores were significantly higher in the PD than in the non-PD group (p = 0.003). Survival was significantly shorter for patients with high F-NLR scores and GPS (p = 0.0071 and p = 0.0065, respectively). Multivariate analysis selected the F-NLR score as an independent prognostic factor (p = 0.017).
  
  
  CONCLUSIONS
  A novel grading system based on F-NLR scores, as well as the GPS, appears to have value as a clinical predictor of the therapeutic response of advanced gastric cancer to chemotherapy or chemoradiotherapy and the prognoses of patients.
authors.affiliation: Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Arigami
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Uenosono
authors.forename: Sumiya
authors.initials: S
authors.lastname: Ishigami
authors.forename: Keishi
authors.initials: K
authors.lastname: Okubo
authors.forename: Takashi
authors.initials: T
authors.lastname: Kijima
authors.forename: Shigehiro
authors.initials: S
authors.lastname: Yanagita
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Okumura
authors.forename: Yasuto
authors.initials: Y
authors.lastname: Uchikado
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kijima
authors.forename: Akihiro
authors.initials: A
authors.lastname: Nakajo
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kurahara
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kita
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Mori
authors.forename: Kosei
authors.initials: K
authors.lastname: Maemura
authors.forename: Shoji
authors.initials: S
authors.lastname: Natsugoe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D006801:Humans; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000166:cytology*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000166:cytology*; D017239:Paclitaxel / Q000627:therapeutic use; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000532:radiotherapy; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D005340:Fibrinogen; D017239:Paclitaxel; D002945:Cisplatin