BACKGROUND AND OBJECTIVES: The role of inflammation in cancer development is a well-known phenomenon that may be represented by the neutrophil-lymphocyte ratio (NLR). The present research intends to determine the impact of NLR on the survival outcome of patients with gastric cancer (GC), and to evaluate its use as a stratification factor for the staging groups. METHODS: Data regarding clinical characteristics, surgery, pathology, and follow-up were retrospectively collected from our single-center prospective database. Blood samples were obtained before surgery. RESULTS: A total of 383 patients (231 males) who underwent gastrectomy with lymphadenectomy were evaluated between 2009 and 2016. NLR established cutoff was 2.44, and patients were divided in NLR ≥2.44 (hNLR) and <2.44 (lNLR). hNLR patients (38.4% of the cases) had lower disease-free survival and overall survival (OS) compared to lNLR patients (P = 0.047 and P = 0.045, respectively). Risk stratification according to NLR value was done in same tumor depth (T4 and <T4), stage (III and <III) and lymph node status (N+ and N-) group of patients. The OS was significantly lower when NLR was high in same tumor depth (P = 0.032) and stage (P = 0.020), but not in same lymph node status patients (P = 0.184). In a multivariate analysis, NLR was an independent factor of worse OS (HR 1.50 95%CI 1.27-4.21, P = 0.048). CONCLUSION: A high NLR was an independent risk factor for reduced survival in GC patients submitted to potentially curative resection. Calculating NLR is easily reproducible and may be incorporated in pre-operative evaluation.
BACKGROUND AND OBJECTIVES: The role of inflammation in cancer development is a well-known phenomenon that may be represented by the neutrophil-lymphocyte ratio (NLR). The present research intends to determine the impact of NLR on the survival outcome of patients with gastric cancer (GC), and to evaluate its use as a stratification factor for the staging groups. METHODS: Data regarding clinical characteristics, surgery, pathology, and follow-up were retrospectively collected from our single-center prospective database. Blood samples were obtained before surgery. RESULTS: A total of 383 patients (231 males) who underwent gastrectomy with lymphadenectomy were evaluated between 2009 and 2016. NLR established cutoff was 2.44, and patients were divided in NLR ≥2.44 (hNLR) and <2.44 (lNLR). hNLR patients (38.4% of the cases) had lower disease-free survival and overall survival (OS) compared to lNLR patients (P = 0.047 and P = 0.045, respectively). Risk stratification according to NLR value was done in same tumor depth (T4 and <T4), stage (III and <III) and lymph node status (N+ and N-) group of patients. The OS was significantly lower when NLR was high in same tumor depth (P = 0.032) and stage (P = 0.020), but not in same lymph node status patients (P = 0.184). In a multivariate analysis, NLR was an independent factor of worse OS (HR 1.50 95%CI 1.27-4.21, P = 0.048). CONCLUSION: A high NLR was an independent risk factor for reduced survival in GC patients submitted to potentially curative resection. Calculating NLR is easily reproducible and may be incorporated in pre-operative evaluation.
Authors: Marina Alessandra Pereira; Marcus Fernando Kodama Pertille Ramos; Andre Roncon Dias; Sheila Friedrich Faraj; Cinthya Dos Santos Cirqueira; Evandro Sobroza de Mello; Bruno Zilberstein; Venancio Avancini Ferreira Alves; Ulysses Ribeiro Journal: Chin J Cancer Res Date: 2018-10 Impact factor: 5.087
Authors: Daniel José Szor; André Roncon Dias; Marina Alessandra Pereira; Marcus Fernando Kodama Pertille Ramos; Bruno Zilberstein; Ivan Cecconello; Ulysses Ribeiro Júnior Journal: Einstein (Sao Paulo) Date: 2019-11-25
Authors: João Paulo Maciel Silva; Fabricio Ferreira Coelho; Alex Jones Flores Cassenote; Vagner Birk Jeismann; Gilton Marques Fonseca; Jaime Arthur Pirola Kruger; José Donizeti de Meira Júnior; Sérgio Carlos Nahas; Paulo Herman Journal: BMC Surg Date: 2022-09-02 Impact factor: 2.030
Authors: Marcus Fernando Kodama Pertille Ramos; Marina Alessandra Pereira; Arthur Youssif Mota Arabi; Melissa Mello Mazepa; Andre Roncon Dias; Ulysses Ribeiro; Bruno Zilberstein; Sergio Carlos Nahas Journal: Med Sci (Basel) Date: 2021-06-25
Authors: Sabine Schiefer; Naita Maren Wirsik; Eva Kalkum; Svenja Elisabeth Seide; Henrik Nienhüser; Beat Müller; Adrian Billeter; Markus W Büchler; Thomas Schmidt; Pascal Probst Journal: Diagnostics (Basel) Date: 2022-02-25