The baseline ratio of neutrophils to lymphocytes is associated with patient prognosis in advanced gastric cancer

Oncology. 2007;73(3-4):215-20. doi: 10.1159/000127412. Epub 2008 Apr 17.

Abstract

Objective: In cancer patients, the balance between neutrophil (N) and lymphocyte (L) cell counts fluctuates with advancing disease. The objective of our study was to determine the prognostic implications of the N/L ratio in the peripheral blood of gastric cancer patients.

Methods: Study participants were identified from a prospective cohort of patients with advanced gastric cancer in Japan (n = 1,220).

Results: The median baseline N/L was 2.58 (range, 0.63-12.7). Univariate analysis revealed that patients with an N/L > pr =2.5 (n = 644) had a significantly poorer prognosis than those with an N/L <2.5 (n = 576; log rank test, p = 0.019 x 10(-12)). The median survival times for these two groups were 239 (95% confidence interval, CI, 217-251 days) and 363 days (95% CI, 334-406 days), respectively, while the 1-year survival rates were 30 (95% CI, 26-34%) and 50% (95% CI, 45-54%), respectively. A multivariate Cox model established a significant relationship between the N/L ratio and survival (adjusted hazard ratio = 1.52; 95% CI, 1.32-1.75; p = 0.077 x 10(-8)).

Conclusions: These results suggest that the N/L ratio is an independent prognostic factor in advanced gastric cancer. Measurement of this ratio may serve as a clinically accessible and useful biomarker for patient survival.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antimetabolites, Antineoplastic / therapeutic use
  • Cohort Studies
  • Drug Combinations
  • Female
  • Follow-Up Studies
  • Humans
  • Leukocyte Count
  • Lymphocytes, Tumor-Infiltrating / pathology*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / drug therapy
  • Neoplasm Recurrence, Local / pathology
  • Neutrophils / pathology*
  • Oxonic Acid / therapeutic use
  • Prognosis
  • Prospective Studies
  • Stomach Neoplasms / blood*
  • Stomach Neoplasms / drug therapy
  • Survival Rate
  • Tegafur / therapeutic use

Substances

  • Antimetabolites, Antineoplastic
  • Drug Combinations
  • S 1 (combination)
  • Tegafur
  • Oxonic Acid