ESMO Asia Virtual Congress 2020

Abstract 162P

Background

It was unclear whether neutrophil/lymphocyte ratio (NLR) in gastric cancer patients are related to anastomotic leakage (AL). We aimed to evaluate the monitoring value of NLR for AL after radical gastrectomy for gastric cancer.

Methods

Two thousand eight hundred and fifty-five patients receiving radical total gastrectomy with Roux-en-Y esophagojejunal anastomosis for gastric cancer were included, and the cumulative sum (CUSUM) curve was used to dynamically monitor NLR changes.

Results

The incidence of AL was 2.6% (75/2855). The median diagnosis time for AL was 7 (2-17) days, and the median healing time was 19 (5-98) days. According to the CUSUM exceeded the limit value (3σ: 3 standard deviations) or not, the patients were divided into ≥3σ group and <3σ group. The 5 dead patients were in the ≥3σ group, and the median healing time of the other patients was 32 (7-98) days, which was longer than that of patients in the <3σ group [11 (5-28) days, p<0.001]. And 43.5% of patients in the ≥3σ group had severe complications (Clavien-Dindo grade ≥3), which were higher than those in the <3σ group (17.2%, p=0.019). Baseline NLR <2.5, AL occurred <7 days, and CUSUM change ≥3σ were independent risk factors affecting delayed healing (>19 days) or death. The area under curve (AUC) of receiver operating characteristic (ROC) of the scoring system was 0.913. The healing rate of patients in low, medium and high-risk group ≤19 days was 95.7%, 47.4% and 6.1%, respectively.

Conclusions

NLR can dynamically monitor the healing process of AL. The scoring system constructed based on NLR can effectively identify high-risk populations with delayed AL healing or death, providing an objective basis to develop a reasonable treatment plan.