title: Pretreatment platelet-to-lymphocyte ratio is associated with the response to first-line chemotherapy and survival in patients with metastatic gastric cancer.
abstract: BACKGROUND
  Several studies have shown that platelet-to-lymphocyte ratio (PLR) is a prognostic factor for various cancers. However, there is no study about the role of PLR in predicting response to first-line chemotherapy of metastatic gastric cancer. Therefore, this study aimed to establish whether PLR is associated with the response to first-line chemotherapy and survival in patients with metastatic gastric cancer.
  
  
  METHODS
  We enrolled 273 patients diagnosed with metastatic gastric cancer. The best cut-off value of PLR to predict chemotherapeutic response was chosen by receiver operating characteristic (ROC) curve analysis. Prognostic significance was determined using the log-rank test and multivariate Cox regression analysis.
  
  
  RESULTS
  Based on the cut-off value of PLR, patients were divided into a low PLR group and high PLR group. In logistic regression analysis, the low PLR group had a significantly higher disease control rate than the high PLR group had (91.3 vs 76.1%, P=.002), and PLR was an independent risk factor for response to first-line chemotherapy (odds ratio [OR]: 3.256; 95% confidence interval [CI]: 1.521-6.969; P=.002). The low PLR group had significantly longer overall survival (OS) than the high PLR group had (13.4 vs 9.2 months; P=.020). Multivariate survival analysis showed that PLR was significantly associated with OS [hazard ratio (HR): 1.002; 95% CI: 1.000-1.003; P=.020].
  
  
  CONCLUSIONS
  Pre-treatment PLR is associated with the response rate to first-line chemotherapy and survival outcomes in patients with metastatic gastric cancer.
authors.affiliation: Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, China.|Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, China.|Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, China.
authors.forename: Jinglei
authors.initials: J
authors.lastname: Qu
authors.affiliation: Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, China.|Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, China.
authors.forename: Zhi
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, China.|Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, China.
authors.forename: Xiaofang
authors.initials: X
authors.lastname: Che
authors.affiliation: Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, China.|Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, China.|Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, China.
authors.forename: Yuee
authors.initials: Y
authors.lastname: Teng
authors.affiliation: Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, China.|Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Jin
authors.affiliation: Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, China.|Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, China.
authors.forename: Mingfang
authors.initials: M
authors.lastname: Zhao
authors.affiliation: Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, China.|Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, China.
authors.forename: Yunpeng
authors.identifier: http://orcid.org/0000-0001-9800-4373
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, China.|Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, China.
authors.forename: Xiujuan
authors.initials: X
authors.lastname: Qu
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001792:Blood Platelets / Q000166:cytology*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000556:secondary; D008175:Lung Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000556:secondary; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000166:cytology*; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D012372:ROC Curve; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality / Q000473:pathology
chemical_list: D000970:Antineoplastic Agents
keywords: chemotherapy; gastric cancer; platelet-to-lymphocyte ratio; tumor response