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Prognostic significance of neutrophil lymphocyte ratio and platelet lymphocyte ratio in advanced gastric cancer patients treated with FOLFOX chemotherapy
Open accessAbstract
Background: Several inflammatory response materials could be used for prediction of prognosis of cancer patients. The neutrophil lymphocyte ratio (NLR), and the platelet lymphocyte ratio (PLR) have been introduced for prognostic scoring system in various cancers. The objective of this study was to determine whether the NLR or the PLR would predict the clinical outcomes in advanced gastric cancer patients treated with oxaliplatin/ 5-fluorouracil (FOLFOX). Methods: The study population consisted of 174 advanced gastric cancer patients. Patients were treated with 85 mg/m 2 of oxaliplatin as a 2-h infusion at day 1 plus 20 mg/m 2 of leucovorin over 10 min, followed by 5-FU bolus 400 mg/m 2 and 22-h continuous infusion of 600 mg/m 2 at days 1-2. Treatment was repeated in 2-week intervals. The NLR and PLR were calculated from complete blood counts in laboratory test before and after first cycle of chemotherapy. Results: NLR was a useful prognostic biomarker for predicting inferior overall survival (OS) (p= 0.005), but was not associated with progression free survival (PFS) (p= 0.461). The normalization of NLR after one cycle of chemotherapy was found to be in association with significant improvement in PFS (5.3 months vs. 2.4 months,p< 0.001), and OS (11.9 months vs. 4.6 months,p< 0.001). The normalization of PLR was also associated with longer PFS (5.6 months vs. 3.4 months,p= 0.006), and OS (16.9 months vs. 10.9 months,p= 0.002). In multivariate analysis, changes in NLR were associated with PFS (Hazard ratio (HR): 2.297, 95% confidence interval (CI): 1.429-3.693,p= 0.001). The NLR, (HR: 0.245, 95% CI: 0.092-0.633,p= 0.004), PLR (HR: 0.347, 95% CI: 0.142-0.847,p= 0.020), changes in NLR (HR: 2.468, 95% CI: 1.567-3.886,p< 0.001), and changes in PLR (HR: 1.473, 95% CI: 1.038-2.090,p= 0.030) were independent prognostic markers for OS. Conclusion: This study demonstrates that NLR, PLR, and changes in NLR or PLR are independent prognostic factor for OS in patients with advanced gastric cancer treated with chemotherapy. These specific factors may also help in identifying the patients, who are more sensitive to FOLFOX regimen.
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Coussens, L. M., & Werb, Z. (2002) · Nature · doi:10.1038/nature01322 · Cited by 15,111
Wagner, A. D., Grothe, W., Haerting, J., Kleber, G., Grothey, A., & Fleig, W. E. (2006) · Journal of Clinical Oncology · doi:10.1200/jco.2005.05.0245 · Cited by 1,171 · cited 1×
“Most of the newly diagnosed gastric patients present with either regional or distant metastatic disease where the 5-year overall survival is dismal and is generally accepted as being less than 10% [3].”
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Cited by
Hong, X., Cui, B., Wang, M., Yang, Z., Wang, L., & Xu, Q. (2015) · The Tohoku Journal of Experimental Medicine · doi:10.1620/tjem.236.297 · Cited by 326
Mei, Z., Shi, L., Wang, B., Yang, J., Xiao, Z., Du, P., Wang, Q., & Yang, W. (2017) · Cancer Treatment Reviews · doi:10.1016/j.ctrv.2017.05.005 · Cited by 304
Kim, M.-R., Kim, A.-S., Choi, H.-I., Jung, J.-H., Park, J. Y., & Ko, H.-J. (2020) · PLOS ONE · doi:10.1371/journal.pone.0236445 · Cited by 76
Self-citationGuo, J., Chen, S., Chen, Y., Li, S., & Xu, D. (2018) · Cancer Management and Research · doi:10.2147/cmar.s156071 · Cited by 54
(2014) · PubMed · doi:10.18926/amo/53024 · Cited by 19
Metadata
- Authors
- Lee, S., Oh, S. Y., Kim, S. H., Lee, J. H., Kim, M. C., Kim, K. H., & Kim, H.-J.
- Venue
- BMC Cancer
- Published
- 2013-07-22
- Volume
- 13
- Issue
- 1
- Pages
- 350-350
- ISSN
- 1471-2407 (ISSN-L)
- OpenAlex
- W1988082986
- Cited by
- 281
- References
- 2
- FWCI
- 12.81
- Type
- journal article
- Language
- en
- Open access
- gold
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- Lee, S., Oh, S. Y., Kim, S. H., Lee, J. H., Kim, M. C., Kim, K. H., & Kim, H.-J. (2013). Prognostic significance of neutrophil lymphocyte ratio and platelet lymphocyte ratio in advanced gastric cancer patients treated with FOLFOX chemotherapy. BMC Cancer. https://doi.org/10.1186/1471-2407-13-350
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