Prognostic significance of neutrophil to lymphocyte ratio (NLR) in patients (pts) with resectable gastric/gastroesophageal junction (GOJ) adenocarcinoma undergoing perioperative chemotherapy

Background

No validated preoperative prognostic markers exist for pts with resectable gastric/GOJ adenocarcinoma (AC). There is evidence that NLR and platelet-to-lymphocyte ratio (PLR) predict outcomes in different types of malignancies. We aimed to explore the prognostic significance of NLR in pts with resectable gastric/GOJ AC undergoing perioperative chemotherapy.

Methods

In this retrospective cohort study, baseline neutrophil, lymphocyte and platelet blood count levels were recorded for all pts with resectable gastric/GOJ AC commenced on neoadjuvant ECX-based chemotherapy (Jul'09-Dec'14). The prognostic significance of baseline characteristics and blood count levels on overall survival (OS) and tumour resectability was tested by Cox-regression analysis. All comparisons were two-sided with level of significance p 

Results

Of 368 pts included, 95 pts (26%) had gastric and 273 (74%) had GOJ primaries. ECOG Performance status (PS) was 0 in 133 (36%) and 1-2 in 235 pts (64%); 294 pts (80%) had curative surgery. After a median follow-up of 42 months (mo) (range 0.5-77) 209 (57%) pts were deceased. Increasing NLR associated with shorter OS (HR = 1.13, 95%CI = 1.06-1.19, p 

Conclusions

NLR is highly prognostic in pts with resectable gastric/GOJ AC undergoing neoadjuvant ECX chemotherapy. We propose a baseline prognostic model that might inform prognosis and aid stratification of pts in clinical trials.

Clinical trial identification

n/a

Legal entity responsible for the study

The Christie NHS Foundation Trust

Funding

The Christie NHS Foundation Trust

Disclosure

All authors have declared no conflicts of interest.