Eva Lieto1, Gennaro Galizia2, Annamaria Auricchio1, Francesca Cardella1, Andrea Mabilia1, Nicoletta Basile1, Giovanni Del Sorbo1, Paolo Castellano1, Ciro Romano3, Michele Orditura4, Vincenzo Napolitano1. 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. 2. 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. gennaro.galizia@unicampania.it. 3. Division of Internal Medicine, Department of Medical and Surgical Sciences, Luigi Vanvitelli University of Campania School of Medicine, Naples, Italy. 4. Division of Medical Oncology, F. Magrassi Department of Clinical and Experimental Medicine, Luigi Vanvitelli University of Campania School of Medicine, Naples, Italy.
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.
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 humantumors. However, only a few studies on these biomarkers have been performed in gastric cancerpatients, 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 cancerpatients undergoing surgery.
Entities:
Keywords:
Gastric cancers; Inflammatory and immune status; Lymphocyte-to-monocyte ratio; Neutrophil-to-lymphocyte ratio
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