Elevated preoperative neutrophil to lymphocyte ratio predicts poor survival following resection in late stage gastric cancer
Article first published online: 25 MAY 2011
Copyright © 2011 Wiley-Liss, Inc.
Journal of Surgical Oncology
Volume 104, Issue 5, pages 504–510, October 2011
How to Cite
Jung, M. R., Park, Y. K., Jeong, O., Seon, J. W., Ryu, S. Y., Kim, D. Y. and Kim, Y. J. (2011), Elevated preoperative neutrophil to lymphocyte ratio predicts poor survival following resection in late stage gastric cancer. J. Surg. Oncol., 104: 504–510. doi: 10.1002/jso.21986
- Issue published online: 6 SEP 2011
- Article first published online: 25 MAY 2011
- Manuscript Accepted: 4 MAY 2011
- Manuscript Received: 25 NOV 2010
- National Cancer Center. Grant Number: 0720570
- Chonnam National University Hospital Research Institute of Clinical Medicine. Grant Number: CRI11065-1
- gastric cancer;
- neutrophil to lymphocyte ratio;
- prognostic factor;
- disease-free survival
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.
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.
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).
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.