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Elevated preoperative neutrophil to lymphocyte ratio predicts poor survival following resection in late stage gastric cancer
Author(s) -
Jung Mi Ran,
Park Young Kyu,
Jeong Oh,
Seon Jang Won,
Ryu Seong Yeob,
Kim Dong Yi,
Kim Young Jin
Publication year - 2011
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21986
Subject(s) - medicine , gastroenterology , gastrectomy , stage (stratigraphy) , confidence interval , cancer , neutrophil to lymphocyte ratio , multivariate analysis , lymphocyte , surgery , paleontology , biology
Background Elevated neutrophil to lymphocyte ratio (N/L ratio) has been shown to be a prognostic indicator in various cancers. We aimed to investigate the prognostic significance of the preoperative N/L ratio in late stage gastric cancer. Methods From April 2004 to August 2007, 293 patients who had undergone gastrectomy with curative intent for the AJCC/UICC TNM Stage III or IV gastric cancer were included. N/L ratio was calculated from lymphocyte and neutrophil counts on routine blood tests taken prior to surgery. Results The median follow‐up time for surviving patients was 38.2 months (4.2–65.5 months) and median preoperative N/L ratio was 2.06 (range 0.47–19.73). Subjects were dichotomized at the N/L value of 2.0. A multivariate analysis established a significant relationship between the N/L ratio and overall survival (HR = 1.609; 95% confidence interval, CI, 1.144–2.264; P = 0.006). The cutoff value up to 3.0, the value of 75 percentiles, showed a significant prognostic effect on disease‐free survival (HR = 1.654; 95% CI, 1.088–2.515; P = 0.019). Conclusions The results suggest that the elevated preoperative N/L ratio predicts poor disease‐free and overall survival following resection for late stage gastric cancer. It may be utilized as a simple, reliable prognostic factor for risk stratification and will provide better treatment allocation. J. Surg. Oncol. 2011; 104:504–510. © 2011 Wiley‐Liss, Inc.