scholarly journals Derived neutrophil to lymphocyte ratio and monocyte to lymphocyte ratio may be better biomarkers for predicting overall survival of patients with advanced gastric cancer

2017 ◽  
Vol Volume 10 ◽  
pp. 3145-3154 ◽  
Author(s):  
Shubin Song ◽  
Chunfeng Li ◽  
Sen Li ◽  
Hongyu Gao ◽  
Xiuwen Lan ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Advanced Gastric Cancer ◽  
Neutrophil To Lymphocyte Ratio ◽  
Lymphocyte Ratio

Combining prognostic value of nodal ratio and neutrophil to lymphocyte ratio in completely resected gastric cancer with D2 lymph node dissection.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15565-e15565
Author(s):  
Andres Guevara ◽  
Daniel Enriquez ◽  
Patricia Elizabeth Rioja ◽  
Christian Pacheco ◽  
Victor Castro ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Lymph Node ◽  
Neutrophil To Lymphocyte Ratio ◽  
Node Dissection ◽  
Early Disease ◽  
D2 Lymph Node Dissection ◽  
Lymphocyte Ratio ◽  
Nodal Ratio

e15565 Background: Outcomes in gastric cancer (GC) are still dismal even with complete D2 resection surgery and chemotherapy (CT), therefore identification of prognostic factors is critical to stratify patients at risk of recurrence or death. Nodal ratio (NR) has been recognized as a valuable prognostic factor and neutrophil to lymphocyte ratio (NLR) as systemic inflammation biomarker in some neoplasms. We evaluate overall survival (OS) combining NR and NLR among completely resected GC patients with D2 lymph node dissection in a Peruvian population. Methods: We reviewed retrospectively 791 medical records from GC pts with complete radical D2 resection between 2008 and 2012 at Instituto Nacional de Enfermedades Neoplasicas. We grouped according NR in < 0.2(Low), 0.2-0.5(Intermediate) and > 0.5(High), and NLR with cut-off < 3 and ≥3. We evaluated overall survival combining NR and NLR, also univariate and multivariate cox analysis were performed. OS was based on national registry and cannot evaluate DFS as long most patients return to their primary hospitals to follow-up. Results: Mean age was 60y [rank: 19-89]. Most frequent characteristics were distal localization (52.4%), intestinal subtype (52.6%) and poor differentiated histology (53%). From 791 patients, 156, 194 and 441 were diagnosed at I, II and III CS, respectively. Most patients had nodal involvement (66.8%), 21% and 28.4% received RT and CT, respectively. NLR < 3 was associated to early disease (p < 0.05). In nodal ratio groups, 68.9% had low, 23% intermediate and 8.1% high ratio, no differences were observed with NLR. At 5years median follow up, patients with NLR < 3 and low nodal ratio had better 5-year OS in this nodal group (71% vs 58% on NLR≥3; HR:0.75, 95%CI:0.49-0.94, p = 0.016]), and patients with intermediate and high nodal ratio had worse outcomes (25 and 15% 5year OS, respectively) without differences with NLR. Multivariate analysis showed higher nodal ratio had negative impact on OS. Conclusions: Neutrophil to lymphocyte ratio < 3 was associated to better OS in patients with low nodal ratio ( < 0.2), indeed this approach could be usefull to identify high risks patients with early disease in further studies.

The prognostic value of systemic inflammatory factors in patient with metastatic gastric cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15505-e15505 ◽  
Author(s):  
Georgy M. Manikhas ◽  
Natalia P. Beliak ◽  
Svetlana I. Kutukova ◽  
Natalia V. Zhukova ◽  
Natalia V. Popova ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Inflammatory Markers ◽  
Prognostic Biomarker ◽  
Metastatic Gastric Cancer ◽  
Neutrophil To Lymphocyte Ratio ◽  
C Reactive Protein ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Reactive Protein

e15505 Background: Inflammation seems to be significant factor in carcinogenesis and tumor progression of numerous cancers. Blood calculated neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein (CRP), lactate dehydrogenase (LDH), international normalized ratio (INR) can be evaluated as systemic inflammation markers and prognostic biomarker for many aims: survival outcomes, lymph node metastasis and recurrence, treatment responses in a variety of cancers. The purpose of this study was to investigate baseline associations between blood test parameters (NLR, PLR, LDH, CRP, INR) and their prognostic biomarker role for patient with metastatic gastric cancer, undergoing first-line chemotherapy Methods: Potential baseline inflammatory markers (platelets, neutrophils, lymphocytes, the platelet-lymphocyte ratio, the neutrophil-lymphocyte ratio, the serum C-reactive protein [CRP], the serum LDH, INR) were retrospectively analyzed in 32 patients with metastatic gastric cancer, IV stage (median of age – 60,50). Multivariate analyses were used to identify prognostic factors for overall survival (OS). Baseline values were compared with tumor characteristic and median survival times (MSTs). Results: Multivariate analysis identified due to Cox proportional-hazards regression showed significant longest OS in patients with: localization of primary tumor in antral part of gastric (HR 0,45, 95% CI 0,25-0,80, p = 0,0065); low baseline’s level of WBC (HR 1,17, 95% CI 1.02 - 1,35, p = 0,0219); low baseline’s level of neutrophil (HR 1,18, 95% CI 1.02 - 1,34, p = 0,0251). Level of LDH, CRP, INR didn’t show significant ratio for this cohort of patient. Peritoneum metastatic also didn’t significant affect on OS in patient with metastatic gastric cancer. Patients with low baseline’s platelet to lymphocyte ratio (HR 1,004, 95% CI 1,0009-1,0072, p = 0,0125) and low (from 0 to 3,0) neutrophil to lymphocyte ratio (HR 1,81, 95% CI 1,09-2,99, p = 0,0212) had a significantly longest OS time. Conclusions: Inflammatory markers can predict overall survival in stage IV gastric cancer. Simple and useful.

scholarly journals Decrease in Blood Neutrophil-to-Lymphocyte Ratio Indicates Better Survival After Neoadjuvant Chemotherapy in Patients With Advanced Gastric Cancer

2021 ◽  
Vol 8 ◽  
Author(s):  
Ziyi Liu ◽  
Yahang Liang ◽  
Xiaolong Tang ◽  
Hui Qu
Keyword(s):  
Gastric Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Gastric Cancer ◽  
Proportional Hazards ◽  
Disease Free Survival ◽  
Distant Recurrence ◽  
Cox Proportional Hazards ◽  
Neutrophil To Lymphocyte Ratio ◽  
Curative Surgery ◽  
Lymphocyte Ratio

Introduction: Gastric cancer is the fifth most commonly diagnosed tumor and is the fourth leading cause of cancer-related mortality, worldwide. Due to the low rate of early diagnosis, approximately two-thirds of patients are first diagnosed at an advanced stage. Neoadjuvant chemotherapy (NAC) is recommended for patients with advanced gastric cancer (AGC). The neutrophil-to-lymphocyte ratio (NLR), a combined inflammatory and immunogenic factor, has been universally used for predicting outcomes in AGC patients. Given that NLR is a dynamic process, in this study, we investigated the value of NLR change for the prediction of chemotherapeutic responses and prognosis in patients with AGC.Methods: We retrospectively enrolled 111 patients with AGC who underwent NAC following curative surgery. Patients were divided into two groups according to the NLR change after chemotherapy into the increased and decreased groups. Outcome measures were overall survival (OS) and disease-free survival (DFS). Univariate was calculated by Kaplan-Meier method. Multivariate analysis was performed using the Cox proportional hazards regression model.Results: Post-chemotherapy, NLR increased in 36 patients and decreased in 75 patients. After a median follow-up time of 19 months, six patients developed local recurrence, 23 developed distant recurrence, and 34 died. Patients with reduced post-chemotherapy NLR showed significantly longer OS (p &lt; 0.001) and DFS (p &lt; 0.001). A decrease in the NLR after NAC was an independent indicator associated with better OS (p &lt; 0.001) and DFS (p &lt; 0.001).Conclusions: In patients with AGC, a decrease in NLR after NAC indicated better survival. NLR change could serve as a robust indicator for the efficiency of NAC and prognostic prediction in patients with AGC.

The combination of the changes and the value of neutrophil-to-lymphocyte ratio is useful for prediction of response for advanced gastric cancer treated with nivolumab: A multicenter retrospective study.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 150-150
Author(s):  
Takatsugu Ogata ◽  
Hironaga Satake ◽  
Misato Ogata ◽  
Kentaro Inoue ◽  
Madoka Hamada ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Progression Free Survival ◽  
Complete Response ◽  
Class Ii ◽  
Neutrophil To Lymphocyte Ratio ◽  
Class I ◽  
Class Iii ◽  
Lymphocyte Ratio ◽  
Ecog Ps

150 Background: The ATTRACTION-2 study showed that nivolumab is effective in treating advanced gastric cancer (AGC). Many studies have examined the effectiveness of predictive factors. We previously suggested that neutrophil-to-lymphocyte ratio (NLR) was associated with progression-free survival (PFS) and overall survival. The objective of this study was to determine the effectiveness of the changes of NLR for AGC treated with nivolumab. Methods: Data on patients with AGC treated with nivolumab from November 2014 to December 2017 were collected at two centers. NLRs were calculated before the first cycle (NLRpre) and 2 weeks after the first cycle (NLRpost) of nivolumab, and the changes in NLR (cNLR) was calculated by NLRpost/NLRpre. The association of NLRpre and cNLR with the disease control rate (DCR) and PFS were assessed. Results: Forty-one patients (pts), with the median age of 64 years, were enrolled. Twenty-seven pts were men and 14 were women. Regarding ECOG PS, 34 pts had scores of 0-1 and 7 had a score of 2. The median NLRpre, NLRpost, and cNLR were 2.01 (range, 0.79–18.4), 2.76 (1.27–12.3), and 1.22 (0.16–5.20), respectively. With a median follow-up period of 6.1 months, DCR was 34.1% (complete response [CR], 1 pt; partial response [PR] 3 pts, stable disease [SD], 10 pts). Patients were divided into 3 classes: 8 in Class I (NLRpre≤5 and cNLR≤ 1); 17 in Class II (NLRpre ≤ 5 and 1 < cNLR≤ 2); and 16 in Class III (NLRpre> 5 or cNLR > 2). There were 8 pts, 17 pts, and 16 pts in Class I, II, and III, respectively. DCRs of Class I, II, and III was 87.5% (CR, 1 pt; PR, 2 pts; SD 4 pts), 29.4% (PR, 1 pts; SD 4 pts), and 12.5% (SD 2 pts), respectively. The median PFS was 2.0 months (mo), and it was longer in Class I than in Classes II+III (5.6 vs. 1.4 mo; p = 0.017) and shorter in Class III than in Classes I+II (3.1 vs. 1.3 mo; p = 0.008). The median PFS was 2.0 months (mo). The median PFS was longer in Class I compared with in Class II+III (5.6 vs 1.4 mo; p = 0.017). The median PFS was shorter in Class III compared with in Class I+II (3.1 vs 1.3 mo; p = 0.008). Conclusions: The combined use of NLRpre and cNLR seemed to be effective in predicting the response of AGC to nivolumab.

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