The clinical impact of change in the neutrophil to lymphocyte ratio during the perioperative period in gastric cancer patients who receive curative treatment

Abstract

Abstract Aim Recently, change in the neutrophil to lymphocyte ratio (cNLR) has been shown to be a promising prognostic marker in some malignancies. The aim of the present study was to evaluate the clinical impact of the cNLR in gastric cancer patients who received curative resection. Patients and methods The present study included 450 patients who underwent curative treatment for gastric cancer between 2013 and 2017. The cNLR was defined as follows: cNLR = NLR at 1 month after surgery-NLR at 1 week before surgery. The prognosis and clinicopathological parameters of the increased cNLR and decreased cNLR groups were analyzed. Results The OS stratified by each clinical factor was compared using the log-rank test, and a significant difference was observed using a cutoff value of cNLR − 0.762. When comparing the patient background factors between the increased cNLR (≥ 0.762) and decreased cNLR (< 0.762) groups, there were no significant differences in age, sex, T status, or N status. In the increased cNLR group, the OS rates at 3 and 5 years after surgery were 87.5% and 77.3%, respectively, while those in the decreased cNLR group were 92.8% and 87.3%; which amounted to a statistically significant difference. The univariate and multivariate analyses of factors associated with OS showed that cNLR was a significant prognostic factor. When the postoperative course was compared between the two groups, the incidence rates of postoperative surgical complications and other-cause death were significantly higher in the increased cNLR group. Conclusion The cNLR is a significant risk factor in gastric cancer patients. Therefore, the cNLR is a promising prognostic factor for gastric cancer patients.