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- Title
Prognostic significance of neutrophil lymphocyte ratio and platelet lymphocyte ratio in advanced gastric cancer patients treated with FOLFOX chemotherapy.
- Authors
Suee Lee; Sung Yong Oh; Sung Hyun Kim; Ji Hyun Lee; Min Chan Kim; Ki Han Kim; Hyo-Jin Kim; Lee, Suee; Oh, Sung Yong; Kim, Sung Hyun; Lee, Ji Hyun; Kim, Min Chan; Kim, Ki Han; Kim, Hyo-Jin
- Abstract
<bold>Background: </bold>Several inflammatory response materials could be used for prediction of prognosis of cancer patients. The neutrophil lymphocyte ratio (NLR), and the platelet lymphocyte ratio (PLR) have been introduced for prognostic scoring system in various cancers. The objective of this study was to determine whether the NLR or the PLR would predict the clinical outcomes in advanced gastric cancer patients treated with oxaliplatin/ 5-fluorouracil (FOLFOX).<bold>Methods: </bold>The study population consisted of 174 advanced gastric cancer patients. Patients were treated with 85 mg/m2 of oxaliplatin as a 2-h infusion at day 1 plus 20 mg/m2 of leucovorin over 10 min, followed by 5-FU bolus 400 mg/m2 and 22-h continuous infusion of 600 mg/m2 at days 1-2. Treatment was repeated in 2-week intervals. The NLR and PLR were calculated from complete blood counts in laboratory test before and after first cycle of chemotherapy.<bold>Results: </bold>NLR was a useful prognostic biomarker for predicting inferior overall survival (OS) (p = 0.005), but was not associated with progression free survival (PFS) (p = 0.461). The normalization of NLR after one cycle of chemotherapy was found to be in association with significant improvement in PFS (5.3 months vs. 2.4 months, p < 0.001), and OS (11.9 months vs. 4.6 months, p < 0.001). The normalization of PLR was also associated with longer PFS (5.6 months vs. 3.4 months, p = 0.006), and OS (16.9 months vs. 10.9 months, p = 0.002). In multivariate analysis, changes in NLR were associated with PFS (Hazard ratio (HR): 2.297, 95% confidence interval (CI): 1.429-3.693, p = 0.001). The NLR, (HR: 0.245, 95% CI: 0.092-0.633, p = 0.004), PLR (HR: 0.347, 95% CI: 0.142-0.847, p = 0.020), changes in NLR (HR: 2.468, 95% CI: 1.567-3.886, p < 0.001), and changes in PLR (HR: 1.473, 95% CI: 1.038-2.090, p = 0.030) were independent prognostic markers for OS.<bold>Conclusion: </bold>This study demonstrates that NLR, PLR, and changes in NLR or PLR are independent prognostic factor for OS in patients with advanced gastric cancer treated with chemotherapy. These specific factors may also help in identifying the patients, who are more sensitive to FOLFOX regimen.
- Subjects
NEUTROPHILS; LYMPHOCYTES; OXALIPLATIN; CANCER patients; BIOMARKERS; CANCER chemotherapy; MULTIVARIATE analysis; DIAGNOSIS; ADENOCARCINOMA; STOMACH tumors; FOLINIC acid; RESEARCH; BLOOD platelets; RESEARCH methodology; PROGNOSIS; ANTINEOPLASTIC agents; MEDICAL cooperation; EVALUATION research; ORGANOPLATINUM compounds; FLUOROURACIL; COMPARATIVE studies; LEUKOCYTE count; KAPLAN-Meier estimator; PROPORTIONAL hazards models
- Publication
BMC Cancer, 2013, Vol 13, Issue 1, p1
- ISSN
1471-2407
- Publication type
journal article
- DOI
10.1186/1471-2407-13-350