Decrease in Blood Neutrophil-to-Lymphocyte Ratio Indicates Better Survival After Neoadjuvant Chemotherapy in Patients With Advanced Gastric Cancer

Introduction: Gastric cancer is the fifth most commonly diagnosed tumor and is the fourth leading cause of cancer-related mortality, worldwide. Due to the low rate of early diagnosis, approximately two-thirds of patients are first diagnosed at an advanced stage. Neoadjuvant chemotherapy (NAC) is rec...

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Autores principales:	Ziyi Liu, Yahang Liang, Xiaolong Tang, Hui Qu
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	advanced gastric cancer neutrophil-to-lymphocyte ratio neoadjuvant chemotherapy dynamic change overall survival disease-free survival Surgery RD1-811
Acceso en línea:	https://doaj.org/article/cfa025dbf7a44e96a7dae9512fffb5fa
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spelling	oai:doaj.org-article:cfa025dbf7a44e96a7dae9512fffb5fa2021-11-16T04:58:18ZDecrease in Blood Neutrophil-to-Lymphocyte Ratio Indicates Better Survival After Neoadjuvant Chemotherapy in Patients With Advanced Gastric Cancer2296-875X10.3389/fsurg.2021.745748https://doaj.org/article/cfa025dbf7a44e96a7dae9512fffb5fa2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fsurg.2021.745748/fullhttps://doaj.org/toc/2296-875XIntroduction: Gastric cancer is the fifth most commonly diagnosed tumor and is the fourth leading cause of cancer-related mortality, worldwide. Due to the low rate of early diagnosis, approximately two-thirds of patients are first diagnosed at an advanced stage. Neoadjuvant chemotherapy (NAC) is recommended for patients with advanced gastric cancer (AGC). The neutrophil-to-lymphocyte ratio (NLR), a combined inflammatory and immunogenic factor, has been universally used for predicting outcomes in AGC patients. Given that NLR is a dynamic process, in this study, we investigated the value of NLR change for the prediction of chemotherapeutic responses and prognosis in patients with AGC.Methods: We retrospectively enrolled 111 patients with AGC who underwent NAC following curative surgery. Patients were divided into two groups according to the NLR change after chemotherapy into the increased and decreased groups. Outcome measures were overall survival (OS) and disease-free survival (DFS). Univariate was calculated by Kaplan-Meier method. Multivariate analysis was performed using the Cox proportional hazards regression model.Results: Post-chemotherapy, NLR increased in 36 patients and decreased in 75 patients. After a median follow-up time of 19 months, six patients developed local recurrence, 23 developed distant recurrence, and 34 died. Patients with reduced post-chemotherapy NLR showed significantly longer OS (p < 0.001) and DFS (p < 0.001). A decrease in the NLR after NAC was an independent indicator associated with better OS (p < 0.001) and DFS (p < 0.001).Conclusions: In patients with AGC, a decrease in NLR after NAC indicated better survival. NLR change could serve as a robust indicator for the efficiency of NAC and prognostic prediction in patients with AGC.Ziyi LiuYahang LiangXiaolong TangHui QuFrontiers Media S.A.articleadvanced gastric cancerneutrophil-to-lymphocyte rationeoadjuvant chemotherapydynamic changeoverall survivaldisease-free survivalSurgeryRD1-811ENFrontiers in Surgery, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	advanced gastric cancer neutrophil-to-lymphocyte ratio neoadjuvant chemotherapy dynamic change overall survival disease-free survival Surgery RD1-811
spellingShingle	advanced gastric cancer neutrophil-to-lymphocyte ratio neoadjuvant chemotherapy dynamic change overall survival disease-free survival Surgery RD1-811 Ziyi Liu Yahang Liang Xiaolong Tang Hui Qu Decrease in Blood Neutrophil-to-Lymphocyte Ratio Indicates Better Survival After Neoadjuvant Chemotherapy in Patients With Advanced Gastric Cancer
description	Introduction: Gastric cancer is the fifth most commonly diagnosed tumor and is the fourth leading cause of cancer-related mortality, worldwide. Due to the low rate of early diagnosis, approximately two-thirds of patients are first diagnosed at an advanced stage. Neoadjuvant chemotherapy (NAC) is recommended for patients with advanced gastric cancer (AGC). The neutrophil-to-lymphocyte ratio (NLR), a combined inflammatory and immunogenic factor, has been universally used for predicting outcomes in AGC patients. Given that NLR is a dynamic process, in this study, we investigated the value of NLR change for the prediction of chemotherapeutic responses and prognosis in patients with AGC.Methods: We retrospectively enrolled 111 patients with AGC who underwent NAC following curative surgery. Patients were divided into two groups according to the NLR change after chemotherapy into the increased and decreased groups. Outcome measures were overall survival (OS) and disease-free survival (DFS). Univariate was calculated by Kaplan-Meier method. Multivariate analysis was performed using the Cox proportional hazards regression model.Results: Post-chemotherapy, NLR increased in 36 patients and decreased in 75 patients. After a median follow-up time of 19 months, six patients developed local recurrence, 23 developed distant recurrence, and 34 died. Patients with reduced post-chemotherapy NLR showed significantly longer OS (p < 0.001) and DFS (p < 0.001). A decrease in the NLR after NAC was an independent indicator associated with better OS (p < 0.001) and DFS (p < 0.001).Conclusions: In patients with AGC, a decrease in NLR after NAC indicated better survival. NLR change could serve as a robust indicator for the efficiency of NAC and prognostic prediction in patients with AGC.
format	article
author	Ziyi Liu Yahang Liang Xiaolong Tang Hui Qu
author_facet	Ziyi Liu Yahang Liang Xiaolong Tang Hui Qu
author_sort	Ziyi Liu
title	Decrease in Blood Neutrophil-to-Lymphocyte Ratio Indicates Better Survival After Neoadjuvant Chemotherapy in Patients With Advanced Gastric Cancer
title_short	Decrease in Blood Neutrophil-to-Lymphocyte Ratio Indicates Better Survival After Neoadjuvant Chemotherapy in Patients With Advanced Gastric Cancer
title_full	Decrease in Blood Neutrophil-to-Lymphocyte Ratio Indicates Better Survival After Neoadjuvant Chemotherapy in Patients With Advanced Gastric Cancer
title_fullStr	Decrease in Blood Neutrophil-to-Lymphocyte Ratio Indicates Better Survival After Neoadjuvant Chemotherapy in Patients With Advanced Gastric Cancer
title_full_unstemmed	Decrease in Blood Neutrophil-to-Lymphocyte Ratio Indicates Better Survival After Neoadjuvant Chemotherapy in Patients With Advanced Gastric Cancer
title_sort	decrease in blood neutrophil-to-lymphocyte ratio indicates better survival after neoadjuvant chemotherapy in patients with advanced gastric cancer
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/cfa025dbf7a44e96a7dae9512fffb5fa
work_keys_str_mv	AT ziyiliu decreaseinbloodneutrophiltolymphocyteratioindicatesbettersurvivalafterneoadjuvantchemotherapyinpatientswithadvancedgastriccancer AT yahangliang decreaseinbloodneutrophiltolymphocyteratioindicatesbettersurvivalafterneoadjuvantchemotherapyinpatientswithadvancedgastriccancer AT xiaolongtang decreaseinbloodneutrophiltolymphocyteratioindicatesbettersurvivalafterneoadjuvantchemotherapyinpatientswithadvancedgastriccancer AT huiqu decreaseinbloodneutrophiltolymphocyteratioindicatesbettersurvivalafterneoadjuvantchemotherapyinpatientswithadvancedgastriccancer
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Decrease in Blood Neutrophil-to-Lymphocyte Ratio Indicates Better Survival After Neoadjuvant Chemotherapy in Patients With Advanced Gastric Cancer

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