The Neutrophil-Lymphocyte Ratio Is an Independent Prognostic Factor for Overall Survival in Hispanic Patients with Gastric Adenocarcinoma
High values of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are related with poor prognosis in patients with gastric cancer. However, this association has been rarely assessed in Hispanic populations that show important clinicopathological differences to Asian and Caucasian patients. In this study, we determined the prognostic value of these biomarkers in Hispanic patients from Costa Rica.
Materials and Methods
We retrieved data regarding pre-treatment NLR and PLR, as well as clinical variables from medical records of 381 consecutive gastric cancer patients treated in four major hospitals in Costa Rica between 2009 and 2012. Univariate and multiple Cox regression analyses were performed to assess the value of NLR and PLR as predictors of overall survival (OS) and disease-free survival (DFS). The best cutoff point was based on the maximization of the Log-rank test.
Median follow-up was 13.21 months. In univariate analysis, a NLR ≥ 5 was associated with reduced DFS (hazard ratio (HR) 2.31; 95% confidence interval (CI) 1.78–3.00; p < 0.001) and poor OS (HR 2.24; 95% CI 1.72–2.92; p < 0.001). Similarly, a PLR ≥ 350 was associated with worse DFS (HR 2.28; 95% CI 1.70–3.06; p < 0.001) and poor OS (HR 2.33; 95% CI 1.73–3.13; p < 0.001). After adjustment for potential confounders, multivariate analysis revealed that only the NLR ≥ 5 was independently associated with worse DFS (HR 1.97; 95% CI 1.44–2.47) and OS (HR 1.59; 95%CI 1.15–2.28).
NLR ≥ 5 was independently associated with worse OS and DFS in Hispanic patients with gastric cancer.
KeywordsGastric cancer Lymphocyte Neutrophil Platelet Prognosis
Compliance with Ethical Standards
The study was approved by the Ethical Scientific Committee of the University of Costa Rica (no. 817-B2-371) and the Institutional Scientific Ethics Committee of the Caja Costarricense del Seguro Social (R013-SABI-00048). *The abstract of this manuscript was presented at the ESMO XX World Congress on Gastrointestinal Cancer 2018, Barcelona, Spain.
Conflict of Interest
The authors declare that they have no conflict of interest.
- 1.International Agency for Research on Cancer. World Health Organization. Available at: http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx. Accessed on August 1st, 2017.
- 3.Registro Nacional de Tumores. Ministerio de Salud, Gobierno de Costa Rica. Available at: https://www.ministeriodesalud.go.cr/index.php/vigilancia-de-la-salud/estadisticas-y-bases-de-datos/estadisticas/estadistica-de-cancer-registro-nacional-tumores?limit=5. Accessed on May 26th, 2018.
- 22.Choi JH, Suh YS, Choi Y, et al. Comprehensive analysis of the neutrophil-to-lymphocyte ratio for preoperative prognostic prediction nomogram in gastric cancer. World J Surg. 2018; https://doi.org/10.1007/s00268-018-4510-4.