Pretreatment predictive value of blood neutrophil/lymphocyte ratio in R0 gastric cancer resectability

Gastroenterol Hepatol. 2017 Jan;40(1):1-9. doi: 10.1016/j.gastrohep.2016.03.010. Epub 2016 Apr 30.
[Article in English, Spanish]

Abstract

Introduction: New parameters complementary to clinical TNM classification are needed, to orient preoperative on the possibility of a R0 gastric cancer resection. We analysed the possible predictive value of blood neutrophil/lymphocytic ratio (N/L) in relation to resectability.

Methods: Two hundred and fifty-seven gastric cancers consecutively diagnosed and without neoadjuvant treatment were retrospectively studied. Univariate and multivariate analysis of the frequency of R0 cases was performed between groups with a normal N/L ratio (<5) and pathological N/L ratio (≥5). Furthermore, we studied the subgroup of operated patients (n=156) analysing the frequency of R0 resection according to N/L ratio<5 or≥5.

Results: One hundred and fifty-six patients underwent surgical intervention, of which 139 had R0 resections. A high N/L ratio was registered in 46 cases (17.9%). Globally, resectability was higher in patients with a N/L ratio<5: 59.7% vs. N/L ratio≥5: 28.6% (P<.001; OR=3.76; 95% CI=1.78-8.04). The relation between N/L ratio<5 and R0 resection was confirmed in the multivariate (P=.006; OR=3.86; 95% CI=1.46-10.22). In the operated subgroup, the higher frequency of R0 resection achievement is maintained in cases with N/L ratio<5: 91.3% vs. 72.2% (P=.015; OR=4.04; 95% CI=1.23-13.26).

Conclusions: The presence of a N/L ratio<5 at the diagnosis of a gastric carcinoma is related in a significant and independent way with a higher frequency of R0 tumoral resection, globally. This higher proportion of R0 resection cases in patients with a N/L<5 ratio is confirmed in the subgroup of operated patients.

Keywords: Cociente neutrófilos/linfocitos; Cáncer gástrico; Gastric cancer; Neutrophil/lymphocyte ratio; Resecabilidad; Resectability.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Leukocyte Count
  • Lymphocytes*
  • Male
  • Neoplasm Staging
  • Neutrophils*
  • Predictive Value of Tests
  • Retrospective Studies
  • Stomach Neoplasms / blood*
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery