P-062 - Baseline neutrophil-lymphocyte ratio as a prognostic factor for patients with resectable gastric cancer undergoing adjuvant chemotherapy

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Anti-Cancer Agents & Biologic Therapy
Gastric Cancer
Presenter M.M. Laterza
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors M.M. Laterza, F. Ciardiello, E. Martinelli, A. Petrillo, J. Ventriglia, B. Savastano, A. Diana, G. Tirino, M. Orditura, F. de Vita
  • Second University of Naples, Napoli/IT



A high neutrophil/lymphocyte ratio (NLR) in peripheral blood has been shown to be a strong negative prognostic factor in several types of tumors, such as colorectal, breast, pancreatic and lung cancers, while the results in gastric cancer are still controversial. The aim of our study was to define the prognostic value of pre-surgery NLR in an Italian population of resectable patients with gastric adenocarcinoma (GC).


We retrospectively collected the data for 139 patients (pts.) with histologically confirmed GC who underwent curative resection between April 2006 and December 2014. All pts had a complete blood count record prior the surgery and the NLR was calculated from neutrophil and lymphocyte on this routine test. The survival was calculated by Kaplan-Meyer analysis and Cox regression was used to evaluate the prognostic value of NLR. Software SPSS 16.0 was used for statistical analysis.


From April 2006 to December 2014, we analyzed NLR in 139 pts with GC who had undergone curative surgery followed by adjuvant chemotherapy with Folfox-4 regimen. Patients characteristics were the following: median age was 62 years (range 22 - 87), the male/female ratio was 88/44, ECOG PS was 0 in 94.7% pts and 1 in 5.3% pts; the stage at diagnosis was Ib: 6.7%, IIa: 14.4%, IIb: 30.3%, IIIa: 23.5%, IIIb: 18.2%, IIIc: 6.8%. The median preoperative NLR was 1.81 (range 0.29-12.68) and pts were divided into two groups according to this cut-off value. In the whole group of 132 pts, 42 pts died, while 90 pts are still alive; in this group the 1-, 3-, 5-year survival rate was 94.7%, 73.5% and 68.9% respectively. In the 65pts with low NLR the 1-, 3-, 5-year survival was 98.5%, 76.9% and 72.3% respectively, while in the 67 pts with high NLR was 89.5%, 70.1% and 65.7%. On multivariate analysis, no statistically significant differences were observed between OS in pts with low and high NLR (p= 0.069).


Based on this study carried out in a Caucasian population, we can affirm that NLR isn't a prognostic factor in resectable gastric cancer patients undergoing adjuvant chemotherapy. Further studies in larger reports are required to evaluate the prognostic meaning of NLR in gastric cancer.