Changes in neutrophil /lymphocyte ratio and platelet count after chemotherapy correlate with cheomtherapy response and predicition of prognosis in patients with advanced gastric cancer.

Abstract

e16030 Background: The aim of the study was to investigate the predictive value of neutrophil to lymphocyte ratio(NLR) and platelet count(PLT) in the prediction of chemotherapy response and prognosis in patients with advanced gastric cancer. Methods: In this retrospective study, a total of 260 advanced gastric cancer patients were analyzed and the correlation between NLR, PLT and overall survival (OS) were investigated. The receiver operating curve (ROC) was drawn to determine the optimal critical value of NLR. These cases were included and separated into different groups according to the median values of NLR or PLT. Results: Low baseline NLR level correlated with improved clinicopathological characteristics, including organ-free metastasis, Borramn type I and II, tubular adenocarcinoma and papillary carcinoma. Low baseline PLT level also associated with Borramn classification. Alterations in the NLR and PLT levels were associated with therapeutic efficacy and prognosis. The patients who remained in or switched to the low NLR level had an improved objective response rate(ORR), disease control rate(DCR) and survival ratios. The patients who remained in or switched to the low PLT level had an improved DCR. Univariate analyses showed that pathological type, Borramn typing, changes of NLR, and efficacy of chemotherapy were significant predictors of OS. Multivariate analyses showed that pathological type and efficacy evaluation were independent prognostic factor. Conclusions: This study demonstrated that the changes of NLR and PLT following chemotherapy can predict the chemotherapy results in patients with advanced gastric cancer. But, baseline NLR and PLT level haven’t prognostic value in patients with advanced gastric cancer. However, pathological types and the results of the first therapeutic evaluation could have prognostic value in patients with advanced gastric cancer.