The prognostic role of neutrophil/lymphocyte ratio and monocyte/lymphocyte ratio in advanced stage gastric cancer patients receiving chemotherapy: a single center experience

Abstract

Objective: Several studies revealed that peripheral blood Neutrophil/Lymphocyte ratio (NLR) and Monocyte/Lymphocyte Ratio (MLR) were prognostic in various cancer types. However, there are no excessive information about the prognostic significance of NLR and MLR in patients with advanced gastric cancer. As a result, we examined whether NLR and/or MLR could be used as a prognostic marker to predict survival outcomes in patients with advanced gastric cancer receiving palliative chemotherapy. Method: We retrospectively analyzed 119 patients with gastric cancer receiving chemotherapy. We evaluated the relationship between potential prognostic factors and overall survival (OS) times using the Kaplan-Meier method and Cox regression survival modelling. Results: The median overall survival of the patients was 6.9 (2.1-41.6) months. In univariate analysis, NLR (p< 0.001), ECOG performance status (p< 0.001), presence of liver metastases (p< 0.001) and presence of peritoneal metastases (p< 0.001) were found to be associated with survival. The multivariate survival model showed the high NLR (HR=1.59, 95% CI 1.6-2.40, p= 0.026), the patients with ECOG performance score 2-3 (HR=2.91, 95% CI 1.60-5.27, p<0.001), the presence of liver metastasis (HR=2.10, 95% CI 1.35-3.21, p=0.001) and the presence of peritoneal metastases (HR=2.68, 95% CI 1.72-4.17, p<0.001) as independent predictors of survival. Conclusion: Pretreatment high NLR, ECOG performance status, and presence of liver or peritoneal metastases are powerful prognostic factors in advanced gastric cancer patients. These prognostic factors, which are easily accessible in clinical practice, can be used as helpful tools for clinicians in the management of the disease.

Keywords

• Gastric Cancer
• Chemotherapy
• Survival
• Neutrophil-Lymphocyte Ratio
• Monocyte-Lymphocyte Ratio

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