Abstract
ObjectivesTo evaluate the predictive value of the preoperative lymphocyte-to-monocyte ratio (LMR) for the prognosis of patients with gastric cancer (GC) after radical-intent surgery.MethodsWe retrospectively analyzed 1,810 patients who underwent radical-intent gastrectomy for primary GC from December 2008 to December 2013. X-tile software was used to identify the optimal value for blood LMR. Nomograms were developed to predict overall survival (OS) and recurrence-free survival (RFS) after surgery.ResultsLMR was significantly lower in patients with GC than in matched normal volunteers (P<0.001). As shown by forest plots, the long-term outcomes were poorer in the low LMR group than in the high LMR group when considering subgroups separated by clinical characteristics. Cox regression analysis showed that LMR was an independent prognostic factor for OS (P<0.001) and RFS (P=0.001). Nomograms, combining LMR with age, T stage, and N stage, showed better discriminative abilities than the AJCC staging system did in predicting 5-year survival and recurrence from the time of surgery. The recurrence rate was 30.4% (550/1810) and was significantly higher in the low LMR group than in the high LMR group (P<0.05). The LMR was also closely correlated with liver and lymph node metastases (both P<0.05).ConclusionAs an independent prognostic factor for GC, preoperative LMR can improve the predictability of individual survival and recurrence. Furthermore, because liver and lymph node metastases were more commonly observed in patients with low blood LMR before surgery, these patients should be closely followed after the operation.
Highlights
Gastric cancer (GC) is one of the most common cancer and the second leading cause of cancer-related death worldwide [1]
As shown by forest plots, the long-term outcomes were poorer in the low lymphocyte-to-monocyte ratio (LMR) group than in the high LMR group when considering subgroups separated by clinical characteristics
As an independent prognostic factor for GC, preoperative LMR can improve the predictability of individual survival and recurrence
Summary
Gastric cancer (GC) is one of the most common cancer and the second leading cause of cancer-related death worldwide [1]. Significant progress has been made in surgical techniques and adjuvant therapy; the prognosis of patients with GC remains poor [2]. The systemic inflammatory response was shown to be associated with worse prognosis in multiple tumors [4]. It was reported that the preoperative blood lymphocyte-to-monocyte ratio (LMR) seems to be used as a prognostic indicator for solid tumors [6]. Evidence for the predictive value of the blood LMR in GC remains poor and sufficiently large sample sizes are lacking [7]. The aims of this study were to investigate the predictive value of the preoperative blood LMR for the long-term prognosis of patients with GC after radical-intent surgery and to construct a novel predictive model
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
