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The Neutrophil-Lymphocyte Ratio Is an Independent Prognostic Factor for Overall Survival in Hispanic Patients with Gastric Adenocarcinoma

  • A. Ramos-Esquivel
  • E. Cordero-García
  • D. Brenes-Redondo
  • W. Alpízar-Alpízar
Original Research

Abstract

Introduction

High values of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are related with poor prognosis in patients with gastric cancer. However, this association has been rarely assessed in Hispanic populations that show important clinicopathological differences to Asian and Caucasian patients. In this study, we determined the prognostic value of these biomarkers in Hispanic patients from Costa Rica.

Materials and Methods

We retrieved data regarding pre-treatment NLR and PLR, as well as clinical variables from medical records of 381 consecutive gastric cancer patients treated in four major hospitals in Costa Rica between 2009 and 2012. Univariate and multiple Cox regression analyses were performed to assess the value of NLR and PLR as predictors of overall survival (OS) and disease-free survival (DFS). The best cutoff point was based on the maximization of the Log-rank test.

Results

Median follow-up was 13.21 months. In univariate analysis, a NLR ≥ 5 was associated with reduced DFS (hazard ratio (HR) 2.31; 95% confidence interval (CI) 1.78–3.00; p < 0.001) and poor OS (HR 2.24; 95% CI 1.72–2.92; p < 0.001). Similarly, a PLR ≥ 350 was associated with worse DFS (HR 2.28; 95% CI 1.70–3.06; p < 0.001) and poor OS (HR 2.33; 95% CI 1.73–3.13; p < 0.001). After adjustment for potential confounders, multivariate analysis revealed that only the NLR ≥ 5 was independently associated with worse DFS (HR 1.97; 95% CI 1.44–2.47) and OS (HR 1.59; 95%CI 1.15–2.28).

Conclusions

NLR ≥ 5 was independently associated with worse OS and DFS in Hispanic patients with gastric cancer.

Keywords

Gastric cancer Lymphocyte Neutrophil Platelet Prognosis 

Notes

Compliance with Ethical Standards

The study was approved by the Ethical Scientific Committee of the University of Costa Rica (no. 817-B2-371) and the Institutional Scientific Ethics Committee of the Caja Costarricense del Seguro Social (R013-SABI-00048). *The abstract of this manuscript was presented at the ESMO XX World Congress on Gastrointestinal Cancer 2018, Barcelona, Spain.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Departamento de Farmacología, Escuela de MedicinaUniversidad de Costa RicaSan JoséCosta Rica
  2. 2.Instituto de Investigaciones Farmacéuticas, Facultad de FarmaciaUniversidad de Costa RicaSan PedroCosta Rica
  3. 3.Departamento de Oncología Médica, Caja Costarricense de Seguro SocialHospital Max PeraltaCartagoCosta Rica
  4. 4.Departamento de Bioquímica, Escuela de Medicina and Centro de Investigación en Estructuras Microscópicas (CIEMIC)Universidad de Costa RicaSan PedroCosta Rica

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