Ryoichi Miyamoto1, Satoshi Inagawa2, Naoki Sano2, Sosuke Tadano2, Shinya Adachi2, Masayoshi Yamamoto2. 1. Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan. Electronic address: goodfirst883@gmail.com. 2. Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan.
Abstract
BACKGROUND: The preoperative neutrophil-to-lymphocyte ratio (NLR) is a well-known prognostic marker for gastric cancer patients. However, the utility of the NLR in predicting short-term outcomes in gastric cancer patients remains unclear. Here, we investigated whether the preoperative NLR is a predictor of short-term outcomes in gastric cancer patients. METHODS: We retrospectively evaluated 154 consecutive gastric cancer patients. We compared the perioperative outcomes and median survival times (MSTs). In particular, for stage II/III (UICC, 7th edition) gastric cancer patients, we compared median disease-free survival time (MDFST) between the low- and high-NLR groups. RESULTS: Between the low-NLR group (n = 110) and the high-NLR group (n = 44), significant differences were observed in perioperative outcomes, including postoperative complications (3 (2.7%) vs. 5 (11.3%); p = 0.015), intraoperative blood loss (158 ± 168 g vs. 232 ± 433 g; p = 0.022), and intraoperative blood transfusions (0 vs. 3 (6.8%); p = 0.042). MSTs and MDFSTs were also significantly different (812 vs. 594 days, p = 0.04; and 848 vs. 475 days, p = 0.03, respectively). Multivariate analysis identified the NLR (hazard ratio [HR], 2.015; p = 0.004), Glasgow Prognostic Score (GPS) (HR, 1.533; p = 0.012), and presence of stage III/IV disease (HR, 5.488; p < 0.001), preoperative symptoms (HR, 3.412; p = 0.008), or postoperative complications (HR, 2.698; p < 0.001) as independent prognostic factors. CONCLUSIONS: We suggest that the preoperative NLR is an additional useful predictor of both long-term and short-term outcomes in gastric cancer patients.
BACKGROUND: The preoperative neutrophil-to-lymphocyte ratio (NLR) is a well-known prognostic marker for gastric cancerpatients. However, the utility of the NLR in predicting short-term outcomes in gastric cancerpatients remains unclear. Here, we investigated whether the preoperative NLR is a predictor of short-term outcomes in gastric cancerpatients. METHODS: We retrospectively evaluated 154 consecutive gastric cancerpatients. We compared the perioperative outcomes and median survival times (MSTs). In particular, for stage II/III (UICC, 7th edition) gastric cancerpatients, we compared median disease-free survival time (MDFST) between the low- and high-NLR groups. RESULTS: Between the low-NLR group (n = 110) and the high-NLR group (n = 44), significant differences were observed in perioperative outcomes, including postoperative complications (3 (2.7%) vs. 5 (11.3%); p = 0.015), intraoperative blood loss (158 ± 168 g vs. 232 ± 433 g; p = 0.022), and intraoperative blood transfusions (0 vs. 3 (6.8%); p = 0.042). MSTs and MDFSTs were also significantly different (812 vs. 594 days, p = 0.04; and 848 vs. 475 days, p = 0.03, respectively). Multivariate analysis identified the NLR (hazard ratio [HR], 2.015; p = 0.004), Glasgow Prognostic Score (GPS) (HR, 1.533; p = 0.012), and presence of stage III/IV disease (HR, 5.488; p < 0.001), preoperative symptoms (HR, 3.412; p = 0.008), or postoperative complications (HR, 2.698; p < 0.001) as independent prognostic factors. CONCLUSIONS: We suggest that the preoperative NLR is an additional useful predictor of both long-term and short-term outcomes in gastric cancerpatients.
Authors: V Rodrigues; F Landi; S Castro; R Mast; N Rodríguez; A Gantxegi; J Pradell; M López-Cano; M Armengol Journal: J Gastrointest Surg Date: 2020-07-13 Impact factor: 3.452