Impact of serum albumin concentration and neutrophil–lymphocyte ratio score on gastric cancer prognosis

Abstract

INTRODUCTION/AIM -Serum albumin concentration (COA) and neutrophil-lymphocyte ratio (NLR) could reflect immunological and nutritional status. We aim to evaluate the impact of COA-NLR score on the prognosis of gastric cancer (GC). MATERIAL AND METHODS -We perform a retrospective analysis on a database of 637 GC cases, between January 2010 and December 2017. In 396 patients the inclusion criteria for this study were met (non-resectional or palliative surgery were excluded). COA-NLR score was defined as: COA under 35 g/L and NLR value of 2.585 or higherscore 2; one of these conditionsscore 1; and neitherscore 0. RESULTS -In our population (n=203), 87 patients were classified as score 0, 82 as score 1 and 34 as score 2. COA-NLR score was significantly associated with DFS [HR 1,674; CI95% 1,115 -2,513; p=0,013) and with OS [HR 2,072; CI95% 1,531 -2,805; p<0,001].Kaplan-Meier curves analysis (log-rank test) revealed that a higher score of COA-NLR predicted a worse OS (p<0,001) and DFS (p=0,03). COA-NLR was an independent prognostic factor for OS when adjusted to pStage and age [adjusted HR 1,566; CI95% 1,143; p=0,005].CONCLUSIONS -Preoperative COA-NLR score was significantly associated with worse OS and DFS and, in this way, with worse prognosis on GC patients submitted to curativeintent resectional surgery.

The Memorial Sloan Kettering Prognostic Score: Correlation with survival in patients with advanced gastric cancer

“…There is a growing body of evidence indicating that the combination of preoperative albumin concentration and the NLR holds predictive value for DFS and OS in patients with Stage I-II GC. 22,23 Additionally, neutrophil count and albumin level 1 month after curative surgery reflect long-term prognosis. 24 Previous study has also shown a correlation between higher NLR and lower serum albumin levels and more advanced clinical staging in GC.…”

“…Wang et al demonstrated that the NLR and serum albumin could be combined to provide additional risk stratification for ovarian cancer, 21 it has also been reported that the combination of serum albumin and NLR was significantly associated with OS and disease-free survival (DFS) of GC patients submitted to curative surgery. 22,23 However, whether MPS is a predictor of prognosis of advanced GC has not yet been investigated. Therefore, we performed a retrospective study to examine the prognostic significance of the MPS on the survival outcomes of patients with advanced GC.…”

“…Increasing evidence showed that the MPS may be effective for other tumor types. Wang et al demonstrated that the NLR and serum albumin could be combined to provide additional risk stratification for ovarian cancer, 21 it has also been reported that the combination of serum albumin and NLR was significantly associated with OS and disease‐free survival (DFS) of GC patients submitted to curative surgery 22,23 . However, whether MPS is a predictor of prognosis of advanced GC has not yet been investigated.…”

Prognostic analysis of the plasma fibrinogen combined with neutrophil‐to‐lymphocyte ratio in patients with non–small cell lung cancer after radical resection

“…The neutrophil‐lymphocyte ratio (NLR) reflects the host's inflammatory and immune response status. It has been reported in the literature that the NLR has a substantial impact on the prognosis of many malignant tumors, such as NSCLC, gastric cancer, colorectal cancer, and pancreatic cancer 12–15 . Higher NLR values predict poor prognosis.…”

“…It has been reported in the literature that the NLR has a substantial impact on the prognosis of many malignant tumors, such as NSCLC, gastric cancer, colorectal cancer, and pancreatic cancer. 12 , 13 , 14 , 15 Higher NLR values predict poor prognosis. Correspondingly, coagulation and fibrinolytic system markers, including fibrinogen levels, are associated with tumor progression in different types of malignant tumors.…”