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Predictive Ability of Blood Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in Gastrointestinal Stromal Tumors

Annals of Surgical Oncology volume 22, pages 2343–2350 (2015)Cite this article

Abstract

Background

Recent findings have shown that the neutrophil-to-lymphocyte ratio (NLR) is prognostic for gastrointestinal stromal tumors (GIST). The platelet-to-lymphocyte ratio (PLR) can predict outcome for several other disease sites. This study evaluates the prognostic utility of NLR and PLR for patients with GIST.

Methods

All patients who had undergone surgical resection for primary, localized GIST from 2001 to 2011 were identified from a prospectively maintained database. Recurrence-free survival (RFS) was calculated by the Kaplan–Meier method and compared by the log-rank test. Univariate Cox proportional hazard regression models were used to identify associations with outcome variables.

Results

The study included 93 patients. High PLR [≥245; hazard ratio (HR) 3.690; 95 % confidence interval (CI) 1.066–12.821; p = 0.039], neutrophils (HR 1.224; 95 % CI 1.017–1.473; p = 0.033), and platelets (HR 1.005; 95 % CI 1.001–1.009; p = 0.013) were associated with worse RFS. Patients with high PLR had 2- and 5-year RFS of 57 and 57 %, compared with 94 and 84 % for those with low PLR. High NLR (≥2.04) was not associated with reduced RFS (p = 0.214). Whereas more patients in the high PLR group had large tumors (p = 0.047), more patients in the high NLR group had high mitotic rates (p = 0.016) than in the low-ratio cohorts. Adjuvant therapy was given to 41.2 % of the patients with high PLR (p = 0.022). The patients with high PLR/NLR had worse nomogram-predicted RFS than the patients with low PLR/NLR.

Conclusions

High PLR was associated with reduced RFS. The prognostic ability of PLR to predict recurrence suggests that it may play a role in risk-stratification schemes used to determine which patients will benefit from adjuvant therapy.

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Disclosure

The authors have no conflicts of interest.

Author information

Affiliations

  1. Department of Surgical Oncology, University of Toronto, Toronto, ON, Canada

    Jennifer M. Racz MD, MBA, FRCSC & Fayez A. Quereshy MD, MBA, FRCSC

  2. Division of General Surgery, University Health Network, Toronto, ON, Canada

    Michelle C. Cleghorn MSc, M. Carolina Jimenez MD, MSc, Timothy D. Jackson MD, MPH, FRCSC, FACS, Allan Okrainec MDCM, MHPE, FRCSC, FACS & Fayez A. Quereshy MD, MBA, FRCSC

  3. Department of Biostatistics, Princess Margaret Cancer Center, Toronto, ON, Canada

    Eshetu G. Atenafu MSc, PStat

  4. Department of Surgery, University of Toronto, Toronto, ON, Canada

    Timothy D. Jackson MD, MPH, FRCSC, FACS, Allan Okrainec MDCM, MHPE, FRCSC, FACS & Fayez A. Quereshy MD, MBA, FRCSC

  5. Department of Anesthesia, University Health Network, University of Toronto, Toronto, ON, Canada

    Lakshmikumar Venkat Raghavan MD, FRCPC

Authors
  1. Jennifer M. Racz MD, MBA, FRCSC
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  2. Michelle C. Cleghorn MSc
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  3. M. Carolina Jimenez MD, MSc
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  4. Eshetu G. Atenafu MSc, PStat
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  5. Timothy D. Jackson MD, MPH, FRCSC, FACS
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  6. Allan Okrainec MDCM, MHPE, FRCSC, FACS
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  7. Lakshmikumar Venkat Raghavan MD, FRCPC
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  8. Fayez A. Quereshy MD, MBA, FRCSC
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Correspondence to Fayez A. Quereshy MD, MBA, FRCSC.

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Racz, J.M., Cleghorn, M.C., Jimenez, M.C. et al. Predictive Ability of Blood Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in Gastrointestinal Stromal Tumors. Ann Surg Oncol 22, 2343–2350 (2015). https://doi.org/10.1245/s10434-014-4265-6

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  • DOI: https://doi.org/10.1245/s10434-014-4265-6

Keywords

  • Absolute Lymphocyte Count
  • Adjuvant Imatinib
  • Primary Gist
  • Absolute Platelet Count
  • Recursive Partitioning Method