Abstract
Objective: The prognostic value of neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and systemic immune-inflammatory index has been studied in many cancer types. Our aim is to show the prognostic value of neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and systemic immune-inflammatory index in resected gastric cancer patients. In addition, to determine which parameter is a better predictor of survival. Material and methods: The study included 95 patients resected gastric cancer between 2014-2018. Receiver operating curve analysis was used to determine neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and systemic immune-inflammatory index cut-off values. Systemic immune-inflammatory index was evaluated as neutrophil × platelet/lymphocyte. Long rank and cox regression analysis were used. Results: The median age was 62 (22-84) years. The median overall survival was 33 months. 49 (51.6%) patients were in stage 3 and 46 (48.4 %) patients were in stage 1-2. High neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and systemic immune-inflammatory index values, tumor depth, stage of metastatic lymph node and tumor-node-metastasis stage were poor prognostic factors for overall survival and disease-free survival. When multivariant cox regression analysis was performed, only platelet-lymphocyte ratio was found to be independent prognostic factor (p = 0.037 for overall survival, p = 0.024 for overall survival). Conclusion: High neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and systemic immune-inflammatory index were found to be poor prognostic factors in predicting both overall survival and disease-free survival before treatment in patients who undergo curative resection for gastric cancer. As a result of multivariant analysis, only high platelet-lymphocyte ratio was determined as an independent poor prognostic factor for both overall survival and disease-free survival.
Highlights
Gastric cancer (GC) is the third cause of cancer-related death and the fifth most common worldwide cancer diagnosis [1]
For neutrophil-lymphocyte ratio (NLR), the best cut-off value estimated by receiver operating characteristics (ROC) analysis was 2.66
Overall survival was 21 months in the NLR high group, whereas disease-free survival (DFS) was not reached in the NLR low group (Figure 1a)
Summary
Gastric cancer (GC) is the third cause of cancer-related death and the fifth most common worldwide cancer diagnosis [1]. In 2018, 1.03 million new cases were diagnosed and 780,000 deaths occurred due to gastric cancer [2]. Despite advances in early diagnosis and treatment, one-third of gastric cancer patients who underwent curative surgery had recurrence [3,4,5]. The established prognostic factors were tumor depth (T), stage of metastatic lymph node (N), tumor-node-metastasis (TNM) stage and histological type of tumor [4,6]. The prognosis is different even in patients with the same stage [7]. Studies are conducted to investigate different factors affecting prognosis
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