Prognostic Value of Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio on Survival of Patients Undergoing Palliative Gastrectomy for Metastatic Gastric Carcinoma - A Single Centre Experience

Abstract

BACKGROUND
 Metastatic gastric carcinoma patients usually present late and are not suitable for any form of chemotherapy. Inflammatory markers like neutrophil-lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) may be used to predict survival and for selecting patients for palliative gastrectomy. We wanted to determine the prognostic value of NLR and PLR on survival in metastatic gastric carcinoma patients undergoing palliative gastrectomy.
 METHODS
 We retrospectively analyzed data of 156 metastatic gastric carcinoma patients admitted from August 2011 to January 2020 in a tertiary centre in India. Among these, 43 who underwent palliative gastrectomy and 53 who underwent only best supportive care were included in the study.
 RESULTS
 The optimum cut-off value (NLR - 3.5, PLR - 183.5) was based on the ROC curve. The overall survival was significantly better in the palliative gastrectomy group (4.953 months vs. 2.434 months) (P=0.013). The mean overall survival was also better in the low-PLR group (6.81 vs. 4.81 months) (P= 0.043) and low -NLR group (6.80 vs. 4.91 months) although the latter was not statistically significant (P=0.053).
 CONCLUSIONS
 Patients undergoing palliative gastrectomy for metastatic gastric cancer have significantly better survival, especially those with low PLR and NLR ratios, although the latter was not statistically significant.