Research Article
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Year 2023, , 100 - 104, 31.08.2023
https://doi.org/10.17944/interdiscip.1351892

Abstract

References

  • Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61(2):69-9. https://doi.org/10.3322/caac.20107
  • Anderson WF, Camargo MC, Fraumeni JF Jr, Correa P, Rosenberg PS, Rabkin CS. Age-specific trends in incidence of noncardia gastric cancer in US adults. JAMA. 2010:5;303(17):1723-8. https://doi.org/10.1001/jama.2010.496.
  • Coggon D, Barker DJ, Cole RB, Nelson M. Stomach cancer and food storage. J Natl Cancer Inst. 1989:2;81(15):1178-82. https://doi.org/ 10.1093/jnci/81.15.1178.
  • Lin Y, Zheng Y, Wang HL, Wu J. Global Patterns and Trends in Gastric Cancer Incidence Rates (1988-2012) and Predictions to 2030. Gastroenterology. 2021;161(1):116-127.e8. https://doi.org/ 10.1053/j.gastro.2021.03.023. Epub 2021 Mar 18.
  • In H, Solsky I, Palis B, Langdon-Embry M, Ajani J, Sano T. Validation of the 8th Edition of the AJCC TNM Staging System for Gastric Cancer using the National Cancer Database. Ann Surg Oncol. 2017;24(12):3683-3691 https://doi.org/10.1245/s10434-017-6078-x. Epub 2017 Sep 11.
  • Digklia A, Wagner AD. Advanced gastric cancer: Current treatment landscape and future perspectives. World J Gastroenterol. 2016 28;22(8):2403-14. https://doi.org/10.3748/wjg.v22.i8.2403.
  • Miyamoto R, Inagawa S, Sano N, Tadano S, Adachi S, Yamamoto M. The neutrophil-to-lymphocyte ratio (NLR) predicts short-term and long-term outcomes in gastric cancer patients. Eur J Surg Oncol. 2018;44(5):607-612. https://doi.org/10.1016/j.ejso.2018.02.003. Epub 2018 Feb 13
  • İriağaç Y. , Çavdar E. , Yolcu A. Yaygın Evre Küçük Hücreli Akciğer Kanserinde Lenfosit/Monosit Oranının Prognostik Önemi. Ahi Evran Medical Journal. 2022; 6(1): 71-76.Wang F, Liu ZY, Xia YY, Zhou C, Shen XM, Li XL, Et al. Changes in neutrophil/lymphocyte and platelet/lymphocyte ratios after chemotherapy corre-late with chemotherapy response and prediction of prognosis in patients with unresectable gastric can-cer. Oncol Lett. 2015:10(6):3411-3418. https://doi.org/10.3892/ol.2015.3783. Epub 2015 Oct 8.
  • Lieto E, Galizia G, Auricchio A, Cardella F, Mabilia A, Basile N, et al. Preoperative Neutrophil to Lymphocy-te Ratio and Lymphocyte to Monocyte Ratio are Prognostic Factors in Gastric Cancers Undergoing Sur-gery. J Gastrointest Surg. 2017:21(11):1764-1774 https://doi.org/10.1007/s11605-017-3515-x. Epub 2017 Jul 27.
  • Sun X, Liu X, Liu J, Chen S, Xu D, Li W, Zhan Y, Li Y, Chen Y, Zhou Z. Preoperative neutrophil-to-lymphocyte ratio plus platelet-to-lymphocyte ratio in predicting survival for patients with stage I-II gastric cancer. Chin J Cancer. 2016:24;35(1):57. https://doi.org/10.1186/s40880-016-0122-2.
  • Chen L, Hao Y, Zhu L, Li S, Zuo Y, Zhang Y, Song H, Xue Y. Monocyte to lymphocyte ratio predicts survival in patients with advanced gastric cancer undergoing neoadjuvant chemotherapy. Onco Targets Ther. 2017 :10;10:4007-4016. https://doi.org/10.2147/OTT.S140118.
  • Hsu JT, Wang CC, Le PH, Chen TH, Kuo CJ, Lin CJ, et al. Lymphocyte-to-monocyte ratios predict gastric cancer surgical outcomes. J Surg Res. 2016:15;202(2):284-90 https://doi.org/10.1016/j.jss.2016.01.005. Epub 2016 Jan 11.
  • Ubukata, Hideyuki et al. “Evaluations of interferon-γ/interleukin-4 ratio and neutrophil/lymphocyte ra-tio as prognostic indicators in gastric cancer patients.” Journal of surgical oncology vol. 102,7 (2010): 742-7. https://doi.org/10.1002/jso.21725
  • Seo, Hee Yeon et al. “Prognostic significance of serum vascular endothelial growth factor per platelet co-unt in unresectable advanced gastric cancer patients.” Japanese journal of clinical onco-logy.2010:40,12:1147-53. https://doi.org/10.1093/jjco/hyq111
  • Crumley, A B C et al. “Evaluation of an inflammation-based prognostic score in patients with inoperable gastro-oesophageal cancer.” British journal of cancer. 2006: 94,5: 637-41. https://doi.org/10.1038/sj.bjc.6602998
  • Wang, Qi et al. “The monocyte to lymphocyte ratio not only at baseline but also at relapse predicts poor outcomes in patients with hepatocellular carcinoma receiving locoregional therapy.” BMC gastroentero-logy . 2022: 22,1 98. 4, https://doi.org/10.1186/s12876-022-02180-
  • Toyota, Kazuhiro et al. “Nutritional Status Indicators Affecting the Tolerability of Postoperative Chemot-herapy After Total Gastrectomy in Patients With Gastric Cancer.” Journal of gastric cancer.2022: 22,1: 56-66. https://doi.org/10.5230/jgc.2022.22.e5
  • Jung MR, Park YK, Jeong O, Seon JW, Ryu SY, Kim DY, Kim YJ. Elevated preoperative neutrophil to lymp-hocyte ratio predicts poor survival following resection in late stage gastric cancer. J Surg Oncol. 2011;104(5):504-10. https://doi.org/ 10.1002/jso.21986. Epub 2011 May 25.
  • Shimada H, Takiguchi N, Kainuma O, Soda H, Ikeda A, Cho A, et al. High preoperative neutrophil-lymphocyte ratio predicts poor survival in patients with gastric cancer. Gastric Cancer. 2010;13(3):170-6. https://doi.org/10.1007/s10120-010-0554-3. Epub 2010 Sep 5.
  • Ubukata H, Motohashi G, Tabuchi T, Nagata H, Konishi S, Tabuchi T. Evaluations of interferon-γ/interleukin-4 ratio and neutrophil/lymphocyte ratio as prognostic indicators in gastric cancer patients. J Surg Oncol. 2010:1;102(7):742-7. https://doi.org/10.1002/jso.21725.
  • Jung MR, Park YK, Jeong O, Seon JW, Ryu SY, Kim DY, et al. Elevated preoperative neutrophil to lymp-hocyte ratio predicts poor survival following resection in late stage gastric cancer. J Surg Oncol. 2011;104(5):504-10. https://doi.org/10.1002/jso.21986. Epub 2011 May 25.
  • Cho, I. R., Park, J. C., Park, C. H., Jo, J. H., Lee, H. J.,et al. “Pre-treatment neutrophil to lymphocyte ratio as a prognostic marker to predict chemotherapeutic response and survival outcomes in metastatic ad-vanced gastric cancer.” Gastric cancer: official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association.2014: 17,4: 703-10. https://doi.org/10.1007/s10120-013-0330-2
  • Zhou, D., Wu, Y., Zhu, Y., Lin, Z., Yu, D., Zhang, T. (2020). The Prognostic Value of Neutrophil-to-lymphocyte Ratio and Monocyte-to-lymphocyte Ratio in Metastatic Gastric Cancer Treated with Syste-mic Chemotherapy. Journal of Cancer, 11(14), 4205–4212. https://doi.org/10.7150/jca.39575
  • Zhao, G., Liu, N., Wang, S., Guo, J., Song, X., Qi, Y., et al. Prognostic significance of the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio in patients with metastatic gastric can-cer. Medicine, 99(10), e19405. https://doi.org/10.1097/MD.0000000000019405
  • Chau, Ian et al. “Multivariate prognostic factor analysis in locally advanced and metastatic esophago-gastric cancer--pooled analysis from three multimetre, randomized, controlled trials using individual pa-tient data.” Journal of clinical oncology: official journal of the American Society of Clinical Oncology 2004: 22,12: 2395-403. https://doi.org/10.1200/JCO.2004.08.154
  • Lee J, Lim T, Uhm JE, et al. Prognostic model to predict survival following first-line chemotherapy in pati-ents with metastatic gastric adenocarcinoma. Ann Oncol. 2007;18(5):886-891

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

Year 2023, , 100 - 104, 31.08.2023
https://doi.org/10.17944/interdiscip.1351892

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.

Ethical Statement

Ethical approval was obtained from Tekirdağ Namık Kemal University Clinical Research Ethical Committee with date 31.05.2022 and number 2022.91.05.18, and Helsinki Declaration rules were followed to conduct this study.

References

  • Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61(2):69-9. https://doi.org/10.3322/caac.20107
  • Anderson WF, Camargo MC, Fraumeni JF Jr, Correa P, Rosenberg PS, Rabkin CS. Age-specific trends in incidence of noncardia gastric cancer in US adults. JAMA. 2010:5;303(17):1723-8. https://doi.org/10.1001/jama.2010.496.
  • Coggon D, Barker DJ, Cole RB, Nelson M. Stomach cancer and food storage. J Natl Cancer Inst. 1989:2;81(15):1178-82. https://doi.org/ 10.1093/jnci/81.15.1178.
  • Lin Y, Zheng Y, Wang HL, Wu J. Global Patterns and Trends in Gastric Cancer Incidence Rates (1988-2012) and Predictions to 2030. Gastroenterology. 2021;161(1):116-127.e8. https://doi.org/ 10.1053/j.gastro.2021.03.023. Epub 2021 Mar 18.
  • In H, Solsky I, Palis B, Langdon-Embry M, Ajani J, Sano T. Validation of the 8th Edition of the AJCC TNM Staging System for Gastric Cancer using the National Cancer Database. Ann Surg Oncol. 2017;24(12):3683-3691 https://doi.org/10.1245/s10434-017-6078-x. Epub 2017 Sep 11.
  • Digklia A, Wagner AD. Advanced gastric cancer: Current treatment landscape and future perspectives. World J Gastroenterol. 2016 28;22(8):2403-14. https://doi.org/10.3748/wjg.v22.i8.2403.
  • Miyamoto R, Inagawa S, Sano N, Tadano S, Adachi S, Yamamoto M. The neutrophil-to-lymphocyte ratio (NLR) predicts short-term and long-term outcomes in gastric cancer patients. Eur J Surg Oncol. 2018;44(5):607-612. https://doi.org/10.1016/j.ejso.2018.02.003. Epub 2018 Feb 13
  • İriağaç Y. , Çavdar E. , Yolcu A. Yaygın Evre Küçük Hücreli Akciğer Kanserinde Lenfosit/Monosit Oranının Prognostik Önemi. Ahi Evran Medical Journal. 2022; 6(1): 71-76.Wang F, Liu ZY, Xia YY, Zhou C, Shen XM, Li XL, Et al. Changes in neutrophil/lymphocyte and platelet/lymphocyte ratios after chemotherapy corre-late with chemotherapy response and prediction of prognosis in patients with unresectable gastric can-cer. Oncol Lett. 2015:10(6):3411-3418. https://doi.org/10.3892/ol.2015.3783. Epub 2015 Oct 8.
  • Lieto E, Galizia G, Auricchio A, Cardella F, Mabilia A, Basile N, et al. Preoperative Neutrophil to Lymphocy-te Ratio and Lymphocyte to Monocyte Ratio are Prognostic Factors in Gastric Cancers Undergoing Sur-gery. J Gastrointest Surg. 2017:21(11):1764-1774 https://doi.org/10.1007/s11605-017-3515-x. Epub 2017 Jul 27.
  • Sun X, Liu X, Liu J, Chen S, Xu D, Li W, Zhan Y, Li Y, Chen Y, Zhou Z. Preoperative neutrophil-to-lymphocyte ratio plus platelet-to-lymphocyte ratio in predicting survival for patients with stage I-II gastric cancer. Chin J Cancer. 2016:24;35(1):57. https://doi.org/10.1186/s40880-016-0122-2.
  • Chen L, Hao Y, Zhu L, Li S, Zuo Y, Zhang Y, Song H, Xue Y. Monocyte to lymphocyte ratio predicts survival in patients with advanced gastric cancer undergoing neoadjuvant chemotherapy. Onco Targets Ther. 2017 :10;10:4007-4016. https://doi.org/10.2147/OTT.S140118.
  • Hsu JT, Wang CC, Le PH, Chen TH, Kuo CJ, Lin CJ, et al. Lymphocyte-to-monocyte ratios predict gastric cancer surgical outcomes. J Surg Res. 2016:15;202(2):284-90 https://doi.org/10.1016/j.jss.2016.01.005. Epub 2016 Jan 11.
  • Ubukata, Hideyuki et al. “Evaluations of interferon-γ/interleukin-4 ratio and neutrophil/lymphocyte ra-tio as prognostic indicators in gastric cancer patients.” Journal of surgical oncology vol. 102,7 (2010): 742-7. https://doi.org/10.1002/jso.21725
  • Seo, Hee Yeon et al. “Prognostic significance of serum vascular endothelial growth factor per platelet co-unt in unresectable advanced gastric cancer patients.” Japanese journal of clinical onco-logy.2010:40,12:1147-53. https://doi.org/10.1093/jjco/hyq111
  • Crumley, A B C et al. “Evaluation of an inflammation-based prognostic score in patients with inoperable gastro-oesophageal cancer.” British journal of cancer. 2006: 94,5: 637-41. https://doi.org/10.1038/sj.bjc.6602998
  • Wang, Qi et al. “The monocyte to lymphocyte ratio not only at baseline but also at relapse predicts poor outcomes in patients with hepatocellular carcinoma receiving locoregional therapy.” BMC gastroentero-logy . 2022: 22,1 98. 4, https://doi.org/10.1186/s12876-022-02180-
  • Toyota, Kazuhiro et al. “Nutritional Status Indicators Affecting the Tolerability of Postoperative Chemot-herapy After Total Gastrectomy in Patients With Gastric Cancer.” Journal of gastric cancer.2022: 22,1: 56-66. https://doi.org/10.5230/jgc.2022.22.e5
  • Jung MR, Park YK, Jeong O, Seon JW, Ryu SY, Kim DY, Kim YJ. Elevated preoperative neutrophil to lymp-hocyte ratio predicts poor survival following resection in late stage gastric cancer. J Surg Oncol. 2011;104(5):504-10. https://doi.org/ 10.1002/jso.21986. Epub 2011 May 25.
  • Shimada H, Takiguchi N, Kainuma O, Soda H, Ikeda A, Cho A, et al. High preoperative neutrophil-lymphocyte ratio predicts poor survival in patients with gastric cancer. Gastric Cancer. 2010;13(3):170-6. https://doi.org/10.1007/s10120-010-0554-3. Epub 2010 Sep 5.
  • Ubukata H, Motohashi G, Tabuchi T, Nagata H, Konishi S, Tabuchi T. Evaluations of interferon-γ/interleukin-4 ratio and neutrophil/lymphocyte ratio as prognostic indicators in gastric cancer patients. J Surg Oncol. 2010:1;102(7):742-7. https://doi.org/10.1002/jso.21725.
  • Jung MR, Park YK, Jeong O, Seon JW, Ryu SY, Kim DY, et al. Elevated preoperative neutrophil to lymp-hocyte ratio predicts poor survival following resection in late stage gastric cancer. J Surg Oncol. 2011;104(5):504-10. https://doi.org/10.1002/jso.21986. Epub 2011 May 25.
  • Cho, I. R., Park, J. C., Park, C. H., Jo, J. H., Lee, H. J.,et al. “Pre-treatment neutrophil to lymphocyte ratio as a prognostic marker to predict chemotherapeutic response and survival outcomes in metastatic ad-vanced gastric cancer.” Gastric cancer: official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association.2014: 17,4: 703-10. https://doi.org/10.1007/s10120-013-0330-2
  • Zhou, D., Wu, Y., Zhu, Y., Lin, Z., Yu, D., Zhang, T. (2020). The Prognostic Value of Neutrophil-to-lymphocyte Ratio and Monocyte-to-lymphocyte Ratio in Metastatic Gastric Cancer Treated with Syste-mic Chemotherapy. Journal of Cancer, 11(14), 4205–4212. https://doi.org/10.7150/jca.39575
  • Zhao, G., Liu, N., Wang, S., Guo, J., Song, X., Qi, Y., et al. Prognostic significance of the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio in patients with metastatic gastric can-cer. Medicine, 99(10), e19405. https://doi.org/10.1097/MD.0000000000019405
  • Chau, Ian et al. “Multivariate prognostic factor analysis in locally advanced and metastatic esophago-gastric cancer--pooled analysis from three multimetre, randomized, controlled trials using individual pa-tient data.” Journal of clinical oncology: official journal of the American Society of Clinical Oncology 2004: 22,12: 2395-403. https://doi.org/10.1200/JCO.2004.08.154
  • Lee J, Lim T, Uhm JE, et al. Prognostic model to predict survival following first-line chemotherapy in pati-ents with metastatic gastric adenocarcinoma. Ann Oncol. 2007;18(5):886-891
There are 26 citations in total.

Details

Primary Language English
Subjects Clinical Sciences (Other)
Journal Section Research Articles
Authors

Kubilay Karaboyun 0000-0002-1783-8075

Erdoğan Selçuk Şeber 0000-0001-9081-2405

Early Pub Date August 31, 2023
Publication Date August 31, 2023
Submission Date July 9, 2022
Published in Issue Year 2023

Cite

Vancouver Karaboyun K, Şeber ES. The prognostic role of neutrophil/lymphocyte ratio and monocyte/lymphocyte ratio in advanced stage gastric cancer patients receiving chemotherapy: a single center experience. Interdiscip Med J. 2023;14(49):100-4.