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Pre-treatment neutrophil to lymphocyte ratio as a prognostic marker to predict chemotherapeutic response and survival outcomes in metastatic advanced gastric cancer

 In Rae Cho  ;  Jun Chul Park  ;  Chan Hyuk Park  ;  Jung Hyun Jo  ;  Hyun Jik Lee  ;  Sunyong Kim  ;  Choong Nam Shim  ;  Hyuk Lee  ;  Sung Kwan Shin  ;  Sang Kil Lee  ;  Yong Chan Lee 
 GASTRIC CANCER, Vol.17(4) : 703-710, 2014 
Journal Title
Issue Date
Adult ; Aged ; Disease-Free Survival ; Female ; Humans ; Lymphocyte Count ; Lymphocytes/pathology ; Male ; Middle Aged ; Neutrophils/pathology ; Palliative Care ; Prognosis ; Stomach Neoplasms/drug therapy* ; Stomach Neoplasms/mortality* ; Stomach Neoplasms/pathology*
Gastric cancer ; Chemotherapy ; Survival
BACKGROUND: Several studies have shown that the neutrophil to lymphocyte ratio (NLR) in peripheral blood is a prognostic factor of various cancers. However, there is limited information on the clinical and prognostic significance of NLR in patients with metastatic advanced gastric cancer (AGC). Therefore, we examined whether the NLR can be used as a prognostic marker for predicting chemotherapeutic response and survival outcomes in metastatic AGC patients who are receiving palliative chemotherapy. METHOD: A total of 268 patients diagnosed with metastatic AGC were enrolled. NLR was calculated from complete blood cell count taken before the first chemotherapy treatment. Patients were divided into two groups according to the median value of NLR: a high NLR group and a low NLR group. RESULT: The median follow-up period was 340 days (range 72-1796 days) and median NLR was 3.06 (range 0.18-18.16). The high NLR group (NLR >3.0) contained 138 patients and the low NLR group (NLR ≤3.0) contained 130 patients. Low NLR group patients had a significantly higher chemotherapeutic disease control rate (90.0 % vs. 80.4; P = 0.028), and longer progression-free survival (PFS) and overall survival (OS) than the high NLR group patients (186 vs. 146 days; P = 0.001; 414 vs. 280 days; P < 0.001, respectively). In multivariate analysis, NLR showed a significant association with PFS (HR 1.478; 95 % CI 1.154-1.892; P = 0.002) and OS (HR 1.569; 95 % CI 1.227-2.006; P < 0.001). CONCLUSION: Pretreatment NLR is a useful prognostic marker in patients with metastatic AGC who are undergoing palliative chemotherapy.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sun Yong(김선용)
Park, Jun Chul(박준철) ORCID logo https://orcid.org/0000-0001-8018-0010
Park, Chan Hyuk(박찬혁)
Shin, Sung Kwan(신성관) ORCID logo https://orcid.org/0000-0001-5466-1400
Shim, Choong Nam(심충남)
Lee, Sang Kil(이상길) ORCID logo https://orcid.org/0000-0002-0721-0364
Lee, Yong Chan(이용찬) ORCID logo https://orcid.org/0000-0001-8800-6906
Lee, Hyuk(이혁)
Lee, Hyun Jik(이현직)
Cho, In Rae(조인래)
Jo, Jung Hyun(조중현) ORCID logo https://orcid.org/0000-0002-2641-8873
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