Association between preoperative neutrophil-lymphocyte ratio (NLR) and clinical outcomes in patients with gastric cancer.

Abstract

29 Background: The neutrophil-lymphocyte ratio (NLR) is related to inflammatory status of patients with some cancers. We hypothesize that preoperative NLR is associated with clinical outcomes in patients with gastric adenocarcinoma. Methods: We identified 458 gastric cancer patients who had curative gastrectomy at our institute between 2000 and 2009. All patients had baseline staging including blood test, CT scan and an endoscopic biopsy. Multiple statistical methods were used to analyze clinical outcomes. Results: Most patients were men and most had stage I. The median follow-up time was 74.8 months (95% C.I; 69.5-80.2). The estimated overall survival (OS) and recurrence-free survival (RFS) rate at 5 years were 76.1 +/- 2.1% and 78.6 +/- 2.2%, respectively. We divided 2 groups by NLR that cut off point was 4. In the stage I patients, the median OS and RFS of high and low NLR patients were not different (p=0.63, p=0.92, respectively). However, in stage II, III and IV patients, RFS of those were significantly different (p=0.027). In multivariate analyses, age (p<0.001) and baseline stage (p<0.001) was an independent prognosis factor for OS, and high NLR (p=0.005) and baseline stage (p<0.001) was an independent risk factor for RFS. High NLR had tendency to be associated with poor OS (p=0.069) in multivariate analysis. Conclusions: A high preoperative NLR may be a useful biomarker to predict a poor prognosis patient with gastric cancer before surgery.