Collective neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio symbolizes a new prognostic factor in the survival of gastric cancer patients

Abstract

Background and aims: Due to the high prevalence of gastric cancer and the lack of appropriate prognostic factors, most patients are diagnosed at advanced stages of the disease. Therefore, this study aimed to investigate the relationship between two prognostic factors: neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) to patient survival in gastric cancer patients diagnosed before surgery. Methods: This retrospective study was performed on all gastric cancer patients referred to Kashani Hospital in Shahrekord during 2011-2016. Demographic and biological variables such as NLR and PLR were evaluated. Patient survival was calculated by subtracting the date of disease diagnosis (using endoscopy) from the date of death, and data were analyzed by SPSS version 16. Results: In 100 studied patients, the mean age of patients was 63.79±15.03 (range: 10-92) years. 76% of patients were male and the rest were female. The duration of chronic gastrointestinal disease before cancer diagnosis ranged from one year to 12 years (mean: 3.3±2.06 years). The mean values of inflammatory markers for NLR were 3.37±2.78, and the mean PLR was 147.13±78.93. Patient survival after surgery until death or last follow-up ranged from 0.47 to 63.1 months (mean: 18.29±13.53 months). The mean survival in the survived and dead patients was 16.89±11.44 months and 18.66±14.07 months, respectively. Only NLR had a significant effect on survival (P<0.001) and PLR had no significant effect on survival (P=0.646). Conclusion: With the increase of NLR by one point, the hazard rate of gastric cancer patients after surgery increased by 19%. In fact, the survival rate of gastric cancer patients after surgery decreased significantly with increasing NLR.