Predictive Significance of Ki-67 and Platelet Lymphocyte Ratio in Patients with Gastric Cancer Receiving Neoadjuvant FLOT Chemotherapy.

Abstract

We aimed to determine the predictive significance of Ki-67and platelet lymphocyte ratio (PLR) in patients with gastric cancer (GC), who received fluorouracil, leucovorin, oxaliplatin, docetaxel (FLOT) as neoadjuvant chemotherapy (NAC). Descriptive study. Department of Medical Oncology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey from March 2016 to January 2020. Seventy-five patients with GC, who received FLOT treatment as NAC were included in the study. Ki-67 and PLR, which were examined pre-NAC and aft-NAC, were recorded. Associations between clinical-histopathological parameters with disease-free survival (DFS) and overall survival (OS) were analysed using Kaplan-Meier curves. Cox-regression analysis was used to assess their prognostic values. There was a statistically significant difference between pre-NAC and aft-NAC Ki-67, and aft-NAC PLR values between groups with complete response, partial response, and stable disease aft-NAC (p: 0.023, p: <0.001; and p: 0.001, respectively). When the patients were grouped according to the pre-NAC and aft-NAC Ki-67 changes, a significant difference was found in terms of OS (p< 0.001). High pre-NAC and high aft-NAC Ki-67 were associated with shorter DFS and OS (p: 0.042, p: 0.049; p: 0.027, and p: 0.001, respectively). The high pre-NAC PLR was associated with shorter OS, while the high aft-NAC PLR was associated with shorter DFS (p: 0.018, and p: 0.001, respectively). In multivariate analysis, aft-NAC Ki-67 was found to be an independent prognostic factor for OS. Ki-67 and PLR have predictive significance in GC patients treated with neoadjuvant FLOT. Ki-67 is an independent prognostic marker for OS in gastric cancer. Key Words: FLOT, Gastric cancer, Ki-67, Platelet lymphocyte ratio.