Preoperative Neutrophil‐to‐Lymphocyte Ratio may Predict Postoperative Pneumonia in Stage I–III Gastric Cancer Patients After Curative Gastrectomy: A Retrospective Study

Abstract

Background: Several studies have demonstrated that diverse systemic in ammatory-based prognostic parameters predict poor prognosis in patients with gastric cancer. However, few studies focused on the relationships between postoperative complications and systemic in ammatory-based prognostic parameters after curative gastrectomy. We investigated the relationships between postoperative complications and these parameters to identify parameter-speci c postoperative complications, and assessed the clinical utility of the parameters as predictors of postoperative complications in stage I-III gastric cancer patients.Methods: We retrospectively reviewed 300 patients who underwent curative gastrectomy for stage I-III gastric cancer. A postoperative complication sensitive to the systemic in ammatory-based prognostic parameters was identi ed using a receiver operating characteristic curve, and we evaluated the relationships between the identi ed postoperative complication and other clinical factors.Results: In total, 101 patients (33.7%) had postoperative Clavien-Dindo grade II-IV complications, namely anastomotic complications, such as leak, stenosis, or hemorrhage (35 patients, 11.7%); pancreatic stula ( 16patients, 5.3%); and pneumonia (14 patients, 4.7%). Postoperative pneumonia had the most sensitive relationship to ve systemic in ammatory-based prognostic parameters, and was associated with poor prognosis in stage I-III gastric cancer patients after curative gastrectomy. Multivariate analysis revealed that preoperative neutrophil-to-lymphocyte ratio (odds ratio: 5.228, 95% con dence interval: 1.269-21.541; P=0.022) was an independent predictor of postoperative pneumonia.Conclusions: Preoperative neutrophil-to-lymphocyte ratio may be a useful predictor of postoperative

Peripheral Lymphocyte Subsets Absolute Counts as Feasible Clinical Markers for Predicting Surgical Outcome in Gastric Cancer Patients After Laparoscopic D2 Gastrectomy: A Prospective Cohort Study

“…[39][40][41] Recent studies also showed that preoperative inflammatory markers can effectively predict postoperative complications such as pneumonia and anastomotic leakage in gastric cancer patients after gastrectomy. 42,43 Moreover, a scoring system combined multifactors including inflammatory and nutritional showed promising role in predicting prognosis in gastric cancer. Hirahara et al found that the systemic immune-inflammation index (SII), integrated by peripheral lymphocyte, neutrophil, and platelet counts, was an independent prognostic factor for overall survival in gastric cancer patients.…”

Preoperative neutrophil-to-lymphocyte ratio may contribute to the prediction of postoperative infectious complications in patients with acute appendicitis: a retrospective study

“…The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are well-known systemic inflammatory variables related to the prognosis of colorectal, gastric, and pancreatic cancer [ 17 – 19 ]. Some recent studies suggest that systemic inflammatory variables may be useful for the prediction of postoperative complications in patients with various cancers [ 20 – 22 ]. However, few studies have focused on the relationships between systemic inflammatory variables and postoperative complications in patients with acute appendicitis.…”