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Preoperative Neutrophil to Lymphocyte Ratio and Lymphocyte to Monocyte Ratio are Prognostic Factors in Gastric Cancers Undergoing Surgery

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Cancer outcome is considered to result from the interplay of several factors, among which host inflammatory and immune status are deemed to play a significant role. The neutrophil-to-lymphocyte ratio (NLR) and the lymphocyte-to-monocyte ratio (LMR) have been profitably used as surrogate markers of host immunoinflammatory status and have also been shown to correlate with outcome in several human tumors. However, only a few studies on these biomarkers have been performed in gastric cancer patients, yielding conflicting results.

Methods

Data were retrieved from a prospective institutional database. Overall survival (OS) of 401 patients undergoing surgery for gastric cancer between January 2000 and June 2015 as well as disease-free survival (DFS) rates in 297 radically resected patients were calculated. MaxStat analysis was used to select cutoff values for NLR and LMR.

Results

NLR and LMR did not significantly correlate with tumor stage. Patients with a high NLR and a low LMR experienced more tumor recurrences (p < 0.001) and had a higher hazard ratio (HR) for both OS (HR = 2.4 and HR = 2.10; p < 0.001) and DFS (HR = 2.99 and HR = 2.46; p < 0.001) than low NLR and high LMR subjects. Both biomarkers were shown to independently predict OS (HR = 1.65, p = 0.016; HR = 2.01, p = 0.002, respectively) and DFS (HR = 3.04, p = 0.019; HR = 4.76, p = 0.002, respectively). A score system combining both biomarkers was found to significantly correlate with long-term results.

Conclusions

A simple prognostic score including preoperative NLR and LMR can be used to easily predict outcome in gastric cancer patients undergoing surgery.

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Authors and Affiliations

  1. Division of GI Tract Surgical Oncology, Department of Surgical Sciences, Luigi Vanvitelli University of Campania School of Medicine, c/o II Policlinico, Edificio 17, Via Pansini, 5, 80131, Naples, Italy

    Eva Lieto, Gennaro Galizia, Annamaria Auricchio, Francesca Cardella, Andrea Mabilia, Nicoletta Basile, Giovanni Del Sorbo, Paolo Castellano & Vincenzo Napolitano

  2. Division of Internal Medicine, Department of Medical and Surgical Sciences, Luigi Vanvitelli University of Campania School of Medicine, Naples, Italy

    Ciro Romano

  3. Division of Medical Oncology, F. Magrassi Department of Clinical and Experimental Medicine, Luigi Vanvitelli University of Campania School of Medicine, Naples, Italy

    Michele Orditura

Authors
  1. Eva Lieto
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  2. Gennaro Galizia
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  3. Annamaria Auricchio
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  4. Francesca Cardella
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  5. Andrea Mabilia
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  6. Nicoletta Basile
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  7. Giovanni Del Sorbo
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  8. Paolo Castellano
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  9. Ciro Romano
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  11. Vincenzo Napolitano
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Contributions

E. Lieto, G. Galizia, M. Orditura, and V. Napolitano made a substantial contribution to the concept and design; A. Auricchio, F. Cardella, A. Mabilia, N. Basile, G. Del Sorbo, and P. Castellano collected the data; E. Lieto, G. Galizia, and C. Romano interpreted the data; G. Galizia and M. Orditura performed the statistical analysis; E. Lieto, G. Galizia, C. Romano, M. Orditura, and V. Napolitano drafted the manuscript; A. Auricchio, F: Cardella, A. Mabilia, N. Basile, G. Del Sorbo, and P. Castellano revised the manuscript critically for important intellectual content; all authors approved the final version of the manuscript.

Corresponding author

Correspondence to Gennaro Galizia.

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Lieto, E., Galizia, G., Auricchio, A. et al. Preoperative Neutrophil to Lymphocyte Ratio and Lymphocyte to Monocyte Ratio are Prognostic Factors in Gastric Cancers Undergoing Surgery. J Gastrointest Surg 21, 1764–1774 (2017). https://doi.org/10.1007/s11605-017-3515-x

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  • DOI: https://doi.org/10.1007/s11605-017-3515-x

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