title: Pretreatment predictive value of blood neutrophil/lymphocyte ratio in R0 gastric cancer resectability.
abstract: BACKGROUND
  New parameters complementary to clinical TNM classification are needed, to orient preoperative on the possibility of a R0 gastric cancer resection. We analysed the possible predictive value of blood neutrophil/lymphocytic ratio (N/L) in relation to resectability.
  
  
  METHODS
  Two hundred and fifty-seven gastric cancers consecutively diagnosed and without neoadjuvant treatment were retrospectively studied. Univariate and multivariate analysis of the frequency of R0 cases was performed between groups with a normal N/L ratio (<5) and pathological N/L ratio (≥5). Furthermore, we studied the subgroup of operated patients (n=156) analysing the frequency of R0 resection according to N/L ratio<5 or≥5.
  
  
  RESULTS
  One hundred and fifty-six patients underwent surgical intervention, of which 139 had R0 resections. A high N/L ratio was registered in 46 cases (17.9%). Globally, resectability was higher in patients with a N/L ratio<5: 59.7% vs. N/L ratio≥5: 28.6% (P<.001; OR=3.76; 95% CI=1.78-8.04). The relation between N/L ratio<5 and R0 resection was confirmed in the multivariate (P=.006; OR=3.86; 95% CI=1.46-10.22). In the operated subgroup, the higher frequency of R0 resection achievement is maintained in cases with N/L ratio<5: 91.3% vs. 72.2% (P=.015; OR=4.04; 95% CI=1.23-13.26).
  
  
  CONCLUSIONS
  The presence of a N/L ratio<5 at the diagnosis of a gastric carcinoma is related in a significant and independent way with a higher frequency of R0 tumoral resection, globally. This higher proportion of R0 resection cases in patients with a N/L<5 ratio is confirmed in the subgroup of operated patients.
authors.affiliation: Servicio de Digestivo, Complejo Hospitalario de Navarra, Instituto de Investigaciones Sanitarias de Navarra (IDISNA), Pamplona, Navarra, España. Electronic address: abordamartin@yahoo.es.
authors.forename: Ana
authors.initials: A
authors.lastname: Borda
authors.affiliation: Servicio de Digestivo, Complejo Hospitalario de Navarra, Instituto de Investigaciones Sanitarias de Navarra (IDISNA), Pamplona, Navarra, España.
authors.forename: Juan
authors.initials: J
authors.lastname: Vila
authors.affiliation: Servicio de Digestivo, Complejo Hospitalario de Navarra, Instituto de Investigaciones Sanitarias de Navarra (IDISNA), Pamplona, Navarra, España.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Fernández-Urién
authors.affiliation: Servicio de Digestivo, Complejo Hospitalario de Navarra, Instituto de Investigaciones Sanitarias de Navarra (IDISNA), Pamplona, Navarra, España.
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Zozaya
authors.affiliation: Servicio de Digestivo, Complejo Hospitalario de Navarra, Instituto de Investigaciones Sanitarias de Navarra (IDISNA), Pamplona, Navarra, España.
authors.forename: Ana
authors.initials: A
authors.lastname: Guerra
authors.affiliation: Servicio de Digestivo, Complejo Hospitalario de Navarra, Instituto de Investigaciones Sanitarias de Navarra (IDISNA), Pamplona, Navarra, España.
authors.forename: Fernando
authors.initials: F
authors.lastname: Borda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008214:Lymphocytes; D008297:Male; D009367:Neoplasm Staging; D009504:Neutrophils; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery
keywords: Cociente neutrófilos/linfocitos; Cáncer gástrico; Gastric cancer; Neutrophil/lymphocyte ratio; Resecabilidad; Resectability