A Ramos-Esquivel1, E Cordero-García2, D Brenes-Redondo3, W Alpízar-Alpízar4. 1. Departamento de Farmacología, Escuela de Medicina, Universidad de Costa Rica, Sede Rodrigo Facio, San Pedro, PO BOX 2082, San José, Costa Rica. allan.ramos@ucr.ac.cr. 2. Instituto de Investigaciones Farmacéuticas, Facultad de Farmacia, Universidad de Costa Rica, San Pedro, Costa Rica. 3. Departamento de Oncología Médica, Caja Costarricense de Seguro Social, Hospital Max Peralta, Cartago, Costa Rica. 4. Departamento de Bioquímica, Escuela de Medicina and Centro de Investigación en Estructuras Microscópicas (CIEMIC), Universidad de Costa Rica, San Pedro, Costa Rica.
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.
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 cancerpatients 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.
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