Prognostic Value of Systemic Inflammatory Response Markers in Patients Undergoing Neoadjuvant Chemotherapy and Gastrectomy for Advanced Gastric Cancer in the Eastern European Population

Overview

Journal Cancers (Basel)

Publisher MDPI

Specialty Oncology

Date 2022 Apr 23

PMID 35454903

Authors

Agnieszka Pikula

Magdalena Skorzewska

Zuzanna Pelc

Radoslaw Mlak

Katarzyna Geca

Katarzyna Sedlak

Bogumila Cisel

Magdalena Kwietniewska

Karol Rawicz-Pruszynski

Wojciech P Polkowski

Affiliations

Soon will be listed here.

Abstract

The prognostic value of the systemic inflammatory response markers, namely neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) has not yet been clarified in patients undergoing neoadjuvant chemotherapy (NAC) and gastrectomy for advanced gastric cancer (GC) in the Eastern European population. This study aimed to verify the prognostic value of NLR, PLR, and LMR in GC patients undergoing multimodal treatment. One hundred six GC patients undergoing NAC and gastrectomy between 2012 and 2020 were included. Analysed blood samples were obtained prior to NAC (pre-NAC group) and before surgical treatment (post-NAC group). To evaluate the prognostic value of the NLR, LMR, and PLR, univariable and multivariable overall survival (OS) analyses were performed. In the pre-NAC group, elevated NLR and PLR were associated with significantly higher risk of death (mOS: 36 vs. 87 months; HR = 2.21; = 0.0255 and mOS: 30 vs. 87 months; HR = 2.89; = 0.0034, respectively). Additionally, a significantly higher risk of death was observed in patients with elevated NLR in the post-NAC group (mOS: 35 vs. 87 months; HR = 1.94; = 0.0368). Selected systemic inflammatory response markers (NLR, PLR) are significant prognostic factors in patients with advanced GC treated with NAC and gastrectomy, as shown in the Eastern European population.

Citing Articles

The prognostic utility of the ratio of lymphocyte to monocyte in patients with metastatic colorectal cancer: a systematic review and meta-analysis.

Mei P, Huang L, Lin L, Chen Y, Guo X Front Oncol. 2025; 15:1394154.

PMID: 39963108 PMC: 11830611. DOI: 10.3389/fonc.2025.1394154.

Prognostic value of neutrophil-to-lymphocyte ratio in gastric cancer patients undergoing neoadjuvant chemotherapy: A systematic review and meta-analysis.

Wei Z, Tuo M, Ye C, Wu X, Wang H, Ren W World J Gastrointest Oncol. 2024; 16(11):4477-4488.

PMID: 39554738 PMC: 11551644. DOI: 10.4251/wjgo.v16.i11.4477.

Textbook Neoadjuvant Outcome-Novel Composite Measure of Oncological Outcomes among Gastric Cancer Patients Undergoing Multimodal Treatment.

Pelc Z, Sedlak K, Lesniewska M, Mielniczek K, Chawrylak K, Skorzewska M Cancers (Basel). 2024; 16(9).

PMID: 38730672 PMC: 11083243. DOI: 10.3390/cancers16091721.

Trajectories of neutrophil-to-lymphocyte ratios during neoadjuvant chemotherapy correlate with short- and long-term outcomes in gastric cancer: a group-based trajectory analysis.

Zheng H, Wang F, Zhang L, Li P, Zheng C, Chen Q BMC Cancer. 2024; 24(1):226.

PMID: 38365617 PMC: 10873962. DOI: 10.1186/s12885-024-11950-2.

Association of systemic inflammatory markers and tertiary lymphoid structure with pathological complete response in gastric cancer patients receiving preoperative treatment: a retrospective cohort study.

Wu Y, Zhao J, Wang Z, Liu D, Tian C, Ye B Int J Surg. 2024; 109(12):4151-4161.

PMID: 38259000 PMC: 10720847. DOI: 10.1097/JS9.0000000000000741.

References

Fairweather M, Jajoo K, Sainani N, Bertagnolli M, Wang J . Accuracy of EUS and CT imaging in preoperative gastric cancer staging. J Surg Oncol. 2015; 111(8):1016-20. DOI: 10.1002/jso.23919. View

Toyokawa T, Muguruma K, Yoshii M, Tamura T, Sakurai K, Kubo N . Clinical significance of prognostic inflammation-based and/or nutritional markers in patients with stage III gastric cancer. BMC Cancer. 2020; 20(1):517. PMC: 7271388. DOI: 10.1186/s12885-020-07010-0. View

Liu Z, Ge H, Miao Z, Shao S, Shi H, Dong C . Dynamic Changes in the Systemic Inflammation Response Index Predict the Outcome of Resectable Gastric Cancer Patients. Front Oncol. 2021; 11:577043. PMC: 7947713. DOI: 10.3389/fonc.2021.577043. View

Lin J, Lin J, Xie J, Wang J, Lu J, Chen Q . Complete blood count-based inflammatory score (CBCS) is a novel prognostic marker for gastric cancer patients after curative resection. BMC Cancer. 2020; 20(1):11. PMC: 6943946. DOI: 10.1186/s12885-019-6466-7. View

Yin X, Fang T, Wang Y, Wang Y, Zhang D, Li C . Prognostic significance of serum inflammation indexes in different Lauren classification of gastric cancer. Cancer Med. 2021; 10(3):1103-1119. PMC: 7897904. DOI: 10.1002/cam4.3706. View

Ychou M, Boige V, Pignon J, Conroy T, Bouche O, Lebreton G . Perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma: an FNCLCC and FFCD multicenter phase III trial. J Clin Oncol. 2011; 29(13):1715-21. DOI: 10.1200/JCO.2010.33.0597. View

In H, Solsky I, Palis B, Langdon-Embry M, Ajani J, Sano T . Validation of the 8th Edition of the AJCC TNM Staging System for Gastric Cancer using the National Cancer Database. Ann Surg Oncol. 2017; 24(12):3683-3691. DOI: 10.1245/s10434-017-6078-x. View

Coussens L, Werb Z . Inflammation and cancer. Nature. 2002; 420(6917):860-7. PMC: 2803035. DOI: 10.1038/nature01322. View

Leake P, Cardoso R, Seevaratnam R, Lourenco L, Helyer L, Mahar A . A systematic review of the accuracy and indications for diagnostic laparoscopy prior to curative-intent resection of gastric cancer. Gastric Cancer. 2011; 15 Suppl 1:S38-47. DOI: 10.1007/s10120-011-0047-z. View

10.

Kwee R, Kwee T . Imaging in assessing lymph node status in gastric cancer. Gastric Cancer. 2009; 12(1):6-22. DOI: 10.1007/s10120-008-0492-5. View

11.

Cherny N, Dafni U, Bogaerts J, Latino N, Pentheroudakis G, Douillard J . ESMO-Magnitude of Clinical Benefit Scale version 1.1. Ann Oncol. 2017; 28(10):2340-2366. DOI: 10.1093/annonc/mdx310. View

12.

Al-Batran S, Homann N, Pauligk C, Goetze T, Meiler J, Kasper S . Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma.... Lancet. 2019; 393(10184):1948-1957. DOI: 10.1016/S0140-6736(18)32557-1. View

13.

Sun X, Ai L, Feng Y . The Value of ABO Blood Group and Complete Blood Count for the Prognosis Analysis of Gastric Cancer Patients. Onco Targets Ther. 2020; 13:4627-4633. PMC: 7260541. DOI: 10.2147/OTT.S248065. View

14.

Smyth E, Verheij M, Allum W, Cunningham D, Cervantes A, Arnold D . Gastric cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2016; 27(suppl 5):v38-v49. DOI: 10.1093/annonc/mdw350. View

15.

Hirahara N, Matsubara T, Fujii Y, Kaji S, Kawabata Y, Hyakudomi R . Comparison of the prognostic value of immunoinflammation-based biomarkers in patients with gastric cancer. Oncotarget. 2020; 11(27):2625-2635. PMC: 7343633. DOI: 10.18632/oncotarget.27653. View

16.

Mohri Y, Tanaka K, Ohi M, Yokoe T, Miki C, Kusunoki M . Prognostic significance of host- and tumor-related factors in patients with gastric cancer. World J Surg. 2009; 34(2):285-90. DOI: 10.1007/s00268-009-0302-1. View

17.

Nakamura N, Kinami S, Tomita Y, Miyata T, Fujita H, Takamura H . The neutrophil/lymphocyte ratio as a predictor of successful conversion surgery for stage IV gastric cancer: a retrospective study. BMC Cancer. 2020; 20(1):363. PMC: 7191721. DOI: 10.1186/s12885-020-06884-4. View

18.

Lin J, Wang Z, Huang Y, Xie J, Wang J, Lu J . Dynamic Changes in Pre- and Postoperative Levels of Inflammatory Markers and Their Effects on the Prognosis of Patients with Gastric Cancer. J Gastrointest Surg. 2020; 25(2):387-396. PMC: 7904717. DOI: 10.1007/s11605-020-04523-8. View

19.

Grenader T, Waddell T, Peckitt C, Oates J, Starling N, Cunningham D . Prognostic value of neutrophil-to-lymphocyte ratio in advanced oesophago-gastric cancer: exploratory analysis of the REAL-2 trial. Ann Oncol. 2016; 27(4):687-92. DOI: 10.1093/annonc/mdw012. View

20.

Caro J, Salas M, Ward A, Goss G . Anemia as an independent prognostic factor for survival in patients with cancer: a systemic, quantitative review. Cancer. 2001; 91(12):2214-21. View