Elevated preoperative neutrophil to lymphocyte ratio predicts poor survival following resection in late stage gastric cancer

Authors

  • Mi Ran Jung MD,

    1. Division of Gastroenterologic Surgery, Department of Surgery, Chonnam National University Medical School, Gwangju, Korea
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  • Young Kyu Park MD,

    Corresponding author
    1. Division of Gastroenterologic Surgery, Department of Surgery, Chonnam National University Medical School, Gwangju, Korea
    • Division of Gastroenterologic Surgery, Department of Surgery, Chonnam National University Hwasun Hospital, 160 Ilsimri Hwasun-eup, Hwasun-gun, Jeonnam 519-809, Korea. Fax: 82-61-379-7661===

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  • Oh Jeong MD,

    1. Division of Gastroenterologic Surgery, Department of Surgery, Chonnam National University Medical School, Gwangju, Korea
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  • Jang Won Seon MD,

    1. Division of Gastroenterologic Surgery, Department of Surgery, Chonnam National University Medical School, Gwangju, Korea
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  • Seong Yeob Ryu MD,

    1. Division of Gastroenterologic Surgery, Department of Surgery, Chonnam National University Medical School, Gwangju, Korea
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  • Dong Yi Kim MD,

    1. Division of Gastroenterologic Surgery, Department of Surgery, Chonnam National University Medical School, Gwangju, Korea
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  • Young Jin Kim MD

    1. Division of Gastroenterologic Surgery, Department of Surgery, Chonnam National University Medical School, Gwangju, Korea
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Abstract

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.

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