Does the preoperative platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio predict morbidity after gastrectomy for gastric cancer?

Abstract

Background: Gastric cancer is the 2nd most common cause of cancer-related deaths, and the morbidity rate after surgery is reported to be as high as 46%. The estimation of possible complications, morbidity, and mortality and the ability to specify patients at high risk have become substantial for an intimate follow-up and for proper management in the intensive care unit. This study aimed to determine the prognostic value of the preoperative platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) and their relations with clinical outcomes and complications after gastrectomy for gastric cancer. Methods: This single-center, retrospective cohort study evaluated the data of 292 patients who underwent gastrectomy with curative intent between January 2015 and June 2018 in a tertiary state hospital in Ankara, Turkey. A receiver operating characteristic curve was generated to evaluate the ability of laboratory values to predict clinically relevant postoperative complications. The area under the curve was computed to compare the predictive power of the NLR and PLR. Then, the cutoff points were selected as the stratifying values for the PLR and NLR. Results: The area under the curve values of the PLR (0.60, 95% CI 0.542-0.657) and NLR (0.556, 95% CI 0.497-0.614) were larger than those of the other preoperative laboratory values. For the PLR, the diagnostic sensitivity and specificity were 50.00 and 72.22%, respectively, whereas for the NLR, the diagnostic sensitivity and specificity were 37.50 and 80.16%, respectively. The PLR was related to morbidity, whereas the relation of the NLR with mortality was more prominent. This study demonstrated that the PLR and NLR may predict mortality and morbidity via the Clavien-Dindo classification in gastric cancer patients. The variable was grade ≥ 3 in the Clavien-Dindo classification, including complications requiring surgical or endoscopic interventions, life-threatening complications, and death. Both the PLR and NLR differed significantly according to Clavien-Dindo grade ≥ 3. In this analysis, the PLR was related to morbidity, while the NLR relation with mortality was more intense. Conclusion: Based on the results of the study, the PLR and NLR could be used as independent predictive factors for mortality and morbidity in patients with gastric cancer.

The effect of C Reactive Protein/Albumin ratio and Hematologic Parameters on Prediciting the Prognosis for Emergency Surgical Patients in Intensive Care

“…Platelet/lymphocyte ratio is accepted as a guiding marker from diagnosis to prognosis in many diseases from malignancies to the cerebrovascular events. [16,17] Çelik et al [18] reported that in their study on 334 patients with pediatric acute appendi-citis, the complication rate was significantly higher with the increase in P/L value. Again, Yılmaz et al [9] found that patients with high P/L values had higher mortality rates in their study on 34 mesenteric ischemia patients.…”

Prognostic nutritional index for predicting the clinical outcomes of patients with gastric cancer who received immune checkpoint inhibitors

“…The lymphocyte is part of the immune system and has strong anti-tumor activity (48). Studies have shown that low serum lymphocyte is significantly associated with poor prognosis in patients with gastric cancer (49)(50)(51). ICIs against tumors by relieving the inhibition of tumor cells on the immune system, so nutrition and immune status are important factors for its working (52).…”

Preoperative neutrophil-to-lymphocyte ratio predicts postoperative pulmonary complications in patients with esophageal squamous cell carcinoma receiving preoperative chemoradiotherapy

“…Clinically, the NLR and PLR are quick, routinely available, and easily measurable markers [20]. In addition to predicting prognosis of cancer patients, postoperative NLR or PLR has also been used as a predictor of surgical complications in patients with gastric cancer, pancreatic cancer, and non-small cell lung cancer undergoing surgery [21][22][23][24][25]. For patients with esophageal cancer who underwent esophagectomy, Vulliamy et al [26] reported that postoperative elevated NLR predicted complications of Ivor-Lewis esophagectomy; however, the NLR and PLR were postoperative, not preoperative.…”