Baseline blood neutrophil-lymphocyte ratio to predict treatment response in gastric cancer.

Abstract

52 Background: Several studies have shown that the neutrophil to lymphocyte ratio (NLR) in peripheral blood is a prognostic factor of various cancers. Some biomarkers have been associated with response and prognosis in gastric cancer (GC)identify depends specimens on biopsies and limits their use in clinical practice.Pheripheral blood tests at the time of diagnosis can reflect evolution within the tumor. We evaluated whether the NLR would predict response in patients with GC with treatment neoadyuvant or palliative. Methods: We retrospectively analyzed 190 patients with GC (2011-2013) in National Cancer Institute Mexico. 73 patients were treated with chemotherapy neoadjuvant, 30 with chemoradiotherapy neoadjuvant and 117 patients palliative chemotherapy. NLR were calculated from complete blood counts in laboratory test at diagnosis, cutt of values for the NLR were > 2.5 and < 2.5 using median values reported in previous studies. Results: Characteristics of Patients: male 107, female 83, mean age 54 (20-81).The median number of cycles of chemotherapy before of assess response by tomography was 4. The response rate was partial 20.5%, stable disease 36.3% and progression 43.2%.The median NLR :2.9 (1.1-15.2).84 patients were detected with NLR < 2.5 and 106 patients with NLR greater 2.5. Low NLR group patients had a better disease control (partial response and stable disease) in 68 % vs. 47.1% than high NLR( p = 0.028). Progression of disease was reported in 32 %( n=27) with low NLR and 52.9 %( n=56) of group high NLR (P=0.002). Patients with neoadjuvant treatment 50 underwent surgery 30 with NLR ratio lesser 2.5 and 20 high.There are more advanced disease in patients greater 2.5 NLR than < 2.5 80 vs 56 (p=0.036). Response pathological complete after surgery in 2 patients with a lower value and 1 patient with 2.5. Overall survival in low NLR is longer than in group patients NLR >2.5, 11.3 vs. 9.1 months (p=0.49). Conclusions: These data give evidence that baseline NLR could be predictive marker of response and prognosis in patients with GC undergoing treatment. Limitations to our analysis are a small number of patients, short follow-up and will need to be stratified according to patient characteristics and treatment.