Significance as a recurrence predictor of postoperative neutrophil-lymphocyte ratio in patients with stage II/III gastric cancer: A retrospective study.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 45-45
Author(s):  
Hiroaki Tanaka ◽  
Kazuya Muguruma ◽  
Katsunobu Sakurai ◽  
Takahiro Toyokawa ◽  
Naoshi Kubo ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Lymph Node Metastasis ◽  
Peritoneal Dissemination ◽  
Stage Ii ◽  
Diffuse Type ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Node Metastasis

45 Background: Tumor markers such as carcinoembryonic antigen (CEA) and CA 19-9 are both widely used in the follow up of patients with gastric cancer. However, there are no definitive predictive markers for postopetrative recurrence. It has been reported that preoperative neutrophil lymphocyte ratio (NLR) was associated with prognosis of patients with gastrointestinal cancer. The aim of this study was to examine the impact of postoperative NLR on prediction for postoperative recurrence of gastric cancer. Methods: We retrospective reviewed data from 318 patients with Stage II/III gastric cancer who underwent curative surgical resection followed by adjuvant chemotherapy for between 2006 and 2013. Patients treated with preoperative chemotherapy or multiple cancers were excluded. Results: We found 118 recurrent diseases which mainly included 47 cases with peritoneal dissemination, 27 with distant lymph node metastasis and 24 with liver metastasis. Postoperative NLR was calculated every 6 months and the data at the time of recurrence or last survival were used for analysis. In univariate analysis, histological diffuse type, mascroscopical type 4 cancer, regional lymph node metastasis, lymphatic invasion in primary tumor, tumor diameter, elevated CEA or CA19-9, and elevated NLR were associated with poor prognosis. In multivariate analysis, we found that elevated CA19-9 and NLR were independent predictive markers. Increased NLR was associated with diffuse type, peritoneal dissemination, elevated CEA and preoperative NLR but not with adverse effect of adjuvant chemotherapy. Conclusions: The postoperative NLR might be one of the surrogate markers for recurrence after curative surgery for patients with Stage II/III gastric cancer.

scholarly journals Clinical significance of neutrophil-to-lymphocyte ratio as a predictor of lymph node metastasis in gastric cancer

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Toshiyuki Kosuga ◽  
Tomoki Konishi ◽  
Takeshi Kubota ◽  
Katsutoshi Shoda ◽  
Hirotaka Konishi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Clinical Significance ◽  
Characteristic Curve ◽  
Neutrophil To Lymphocyte Ratio ◽  
Youden Index ◽  
Lymphocyte Ratio ◽  
Node Metastasis ◽  
Higher Sensitivity

Abstract Background Precise staging is indispensable to select the appropriate treatment strategy for gastric cancer (GC); however, the diagnostic accuracy of conventional modalities needs to be improved. This study investigated the clinical significance of the preoperative neutrophil-to-lymphocyte ratio (NLR) for the prediction of pathological lymph node metastasis (pN+) in GC. Methods This was a retrospective study of 429 patients with GC who underwent curative gastrectomy. The predictive ability of NLR for pN+ was examined in comparison with that of computed tomography. Results The preoperative NLR ranged from 0.6 to 10.8 (median, 2.0), and the optimal cut-off value for predicting pN+ was 1.6 according to the receiver operating characteristic curve with the maximal Youden index. Multivariate analysis identified a NLR ≥ 1.6 (odds ratio (OR) 3.171; 95% confidence interval (CI) 1.448–7.235, p = 0.004) and cN+ (OR 2.426; 95% CI 1.221–4.958, p = 0.011) to be independent factors associated with pN+ in advanced GC (cT2-T4). On the other hand, a NLR ≥ 1.6 was not useful for predicting pN+ in early GC (cT1). In advanced GC, a NLR ≥ 1.6 detected pN+ with a higher sensitivity (84.9%) and negative predictive value (NPV) (63.9%) than conventional modalities (50.0 and 51.7%, respectively). When the subjects were limited to those with advanced GC with cN0, the sensitivity and NPV of a NLR ≥ 1.6 for pN+ increased further (90.7 and 81.0%, respectively). Conclusion The preoperative NLR may be a useful complementary diagnostic tool for predicting pN+ in advanced GC because of its higher sensitivity and NPV than conventional modalities.

Risk factors for peritoneal recurrence in stage II/III gastric cancer patients who received S-1 adjuvant chemotherapy after D2 gastrectomy.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 51-51
Author(s):  
Toru Aoyama ◽  
Takaki Yoshikawa ◽  
Junya Shirai ◽  
Hirohito Fujikawa ◽  
Tsutomu Hayashi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Lymph Node Metastasis ◽  
Cancer Patients ◽  
Peritoneal Recurrence ◽  
Tumor Diameter ◽  
Node Metastasis ◽  
Gastric Cancer Patients

51 Background: Peritoneum is still the most frequent site of the recurrence in stage II/III gastric cancer patients although the survival was improved by S-1 adjuvant chemotherapy. The objective of this retrospective study was to clarify the risk factors of peritoneal recurrence in patients who received S-1 adjuvant chemotherapy. Methods: Peritoneal recurrence free survival (P-RFS) was examined in 100 gastric cancer patients who underwent curative D2 surgery, were diagnosed with stage II or III pathologically, and received adjuvant S-1 between June of 2002 and March of 2011. Uni- and multi- variate analyses were performed to identify risk factors by Cox’s proportional hazard analyses. Results: P-RFS was 64.3% at 3 years and 58.8% at 5 years. A total of 18 patients were diagnosed with peritoneal recurrence. Macroscopic tumor diameter, depth of tumor invasion, and lymph node metastasis were the significant factors by univariate analysis, while tumor diameter and lymph node metastasis were the only significant independent risk factors by multivariate analysis. Conclusions: The macroscopic tumor diameter and lymph node metastasis were the most important risk factors for P-RFS. When patients had these risk factors, S-1 was not sufficient to inhibit peritoneal recurrence. When developing a novel adjuvant chemotherapy targeting peritoneal metastasis in the future, clinical trials should be limited to these patients.

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