48 Background: Systemic inflammation arising from complex host-tumor interactions is considered the seventh hallmark of cancer. The aim of this retrospective study was to assess the clinical feasibility of our newly developed ‘lymphocyte-to-C-reactive protein (CRP) ratio’ (LCR) and ‘lymphocyte CRP score’ (LCS) for predicting short- and long-term outcomes in patients with gastric cancer. Methods: In total, 551 patients who underwent gastrectomy for primary gastric cancer at our institution were enrolled in this study. Preoperative LCR was calculated as follows: lymphocyte count (number/µL)/CRP level (mg/dL), and scoring system (LCS) was devised based on the cut-off value of both lymphocytes (1 × 109/L) and CRP (0.3 mg/dL) from previous evidences. Results: Reduced pre-operative LCRs significantly correlated with all of the well-established clinicopathological factors for disease development, including advanced T stage, venous invasion, lymphatic vessel invasion, lymph node metastasis hepatic metastasis, peritoneal metastasis, distant metastasis, and advanced tumor-node-metastasis stage. In the short-term outcome, low pre-operative LCR was an independent predictive factor for post-operative surgical site infection (SSI: OR:1.82, 95.0% CI:1.06–3.12, P = 0.03). In the long-term outcome, low pre-operative LCR was an independent prognostic factor for disease-free survival (DFS: HR:1.53, 95.0% CI:1.01–2.32, P = 0.04) and overall survival (OS: HR:2.03, 95.0% CI:1.42–2.90, P < 0.001), and prognostic impact of pre-operative LCR were verified in patients with metastatic and non-metastatic gastric cancer using the same cut-off value. Furthermore, our developed scoring system using lymphocyte and CRP could also demonstrated all of clinical significance using same difinite cut-off value in GC patients (SSI: OR: 4.43, 95.0% CI:1.75–11.2, P = 0.002; DFS: HR: 3.82, 95.0% CI:1.81–8.06, P < 0.001; OS: HR:2.88, 95.0% CI:1.48–5.61, P = 0.002). Conclusions: Assessment of lymphocytes and CRP could aid physicians in determining surgical risk, and oncological risk, thus faciliating appropriate peri-operative and post-operative management of patients with gastric cancer.
Single determination of C-reactive protein at the time of diagnosis predicts long-term outcome of patients with hepatocellular carcinoma
