Abstract
Introduction. Neutrophil/lymphocyte ratio (NLR) is known as a prognostic for the outcome of the patients with gastric cancer. As no definite risk marker for anastomotic leakage after gastric resection was identified, we investigated the possible role of NLR. Methods. Peripheral blood count for neutrophils and lymphocytes was done at the patient’s admission. We retrospectively evaluated 204 gastric cancer patients, who underwent gastric resection, comparing the values of NLR between the group of patients with anastomotic leakage and those without complications. Results. Using the ROC curve, we found the cutoff value of NLR, which permitted the comparison of the group with low NLR, presenting increased NLR. The cutoff value for NLR was 3.54. Between the two groups, we could observe statistically significant differences in developing fistula (p < 0.01) and complications leading to death (p < 0.025). The odds ratio for patients with NLR greater than 3.54 to develop anastomotic leak was 17.62, compared to those with lower NLR. Conclusion. Peripheral blood NLR proved to be a predictor for anastomotic leakage.
Highlights
Neutrophil/lymphocyte ratio (NLR) is known as a prognostic for the outcome of the patients with gastric cancer
We found a relationship between the NLR value and the presence of anastomotic leakage, so we were able to divide the patients into two groups: (1) those who developed anastomotic leakage, and (2) those with good postoperative outcome through complete anastomosis healing
An inflammatory environment is thought to be essential in the development of most tumors, so systemic inflammation plays a crucial role in cancer occurrence as well as in local and systemic dissemination of neoplastic cells [18]
Summary
Neutrophil/lymphocyte ratio (NLR) is known as a prognostic for the outcome of the patients with gastric cancer. As no definite risk marker for anastomotic leakage after gastric resection was identified, we investigated the possible role of NLR. 204 gastric cancer patients, who underwent gastric resection, comparing the values of NLR between the group of patients with anastomotic leakage and those without complications. Peripheral blood NLR proved to be a predictor for anastomotic leakage. Anastomotic leakage after gastric resections for malignant tumors represents an awful outcome, with high mortality rate, raising the risks of local recurrence and worsening the overall prognosis. Diagnostics 2020, 10, 799 on the drainage tube, creating a localized collection. This happens even if they are partially externalized, maintaining sepsis. Knowing that reducing the number of drainage tubes leads to reduced hospitalization [4], the need for predictive markers of the risk of anastomotic fistula is becoming greater, in order to use, when necessary, more drainage tubes in patients at risk to successfully treat fistulas
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