Prognostic Role of Neutrophil/Lymphocyte Ratio in Resected Gastric Cancer: A Systematic Review and Meta-analysis

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Introduction Multivisceral resection (MVR) is potentially curative for selected gastric cancer patients, supposedly at the cost of increased complications. However, current data comparing MVR to standard gastrectomy (SG) is lacking. Objectives Compare complications and survival after MVR and SG. Methods In a retrospective cohort of 1015 patients with gastric adenocarcinoma, 58 underwent MVR and 466 SG. Groups were compared concerning their characteristics, complications, and survival. Results One hundred seventy‐six patients had postoperative complications. Major complications were more frequent after MVR (P = .002). Surgical mortality was 8.6% and 4.9% for MVR and SG (P = .221). Older age, higher morbidities, and MVR were independent risk factors for major complications. The odds ratio for major complications was 5.89 for MVR with one or two organs and 38.01 for MVR with three or more organs. The pancreas was the most commonly removed organ and pT4b disease were confirmed in 34 (58.6%) of the MVR cases. Disease‐free survival (DFS) was lower in MVR patients (51% vs 77.8%; P < .001), being worse according to the number of organs resected. In pN+ patients, DFS was worse after MVR. DFS was equivalent to pT4b and non‐pT4b in the MVR group. Conclusions Increased morbidity and lower survival are expected for gastric cancer patients undergoing MVR.

Section: Discussionmentioning

confidence: 99%

Multivisceral resection vs standard gastrectomy for gastric adenocarcinoma

Dias

Pereira

Oliveira

et al. 2020

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“…We attributed this difference to the reduction in tumor size and in the peritumoral inflammatory response after NACT. High NLR levels are associated with poor prognosis in gastric tumors 26,27 …”

Section: Discussionmentioning

confidence: 99%

“…High NLR levels are associated with poor prognosis in gastric tumors. 26,27 The pathological results of the NACT were evident. Reduced tumor size, less perineural, lymphatic and venous invasion; and fewer metastatic lymph nodes were observed.…”

Section: Discussionmentioning

confidence: 99%

Impact of neoadjuvant chemotherapy on surgical and pathological results of gastric cancer patients: A case‐control study

Charruf

Ramos

Pereira

et al. 2020

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Background and Objective Neoadjuvant chemotherapy (NACT) followed by radical surgery represents a treatment option for patients with advanced gastric cancer (GC). This case‐control study aimed to evaluate the clinicopathological characteristics and surgical outcomes of GC patients who received NACT, and its impact on survival. Methods We retrospectively reviewed all patients with GC who underwent gastrectomy. A total of 45 cases with NACT were matched with consecutive 45 patients who underwent upfront gastrectomy for the following characteristics: gender, age, gastrectomy type, lymphadenectomy extent, American Society of Anesthesiologists class, histological type, cT and cN. Results NACT group had smaller tumors (4.9 vs 6.8 cm P = .006), lower lymphatic invasion rate (40% vs 73.3%, P = .001), lower venous invasion rate (18% vs 46.7%, P = .003) and lower perineural invasion rate (35% vs 77.8%, P < .0001). The ypTNM stage was lower in patients treated with NACT (P < .001). The major postoperative complication (POC) rate was lower in NACT patients (6.7% vs 24.4%, P = .02), as was hospital length of stay (10.8 vs 17 days, P = .005). Conclusions NACT allowed nodal and tumor downstaging. In addition, patients who underwent NACT had fewer POC and shorter length of hospital stay.

“…Consequently, hematological markers of systemic inflammation can predict prognosis in different neoplasms . Several routine complete blood count variables provide essential clues about different cancers types, such as neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐lymphocyte ratio (PLR) . Such biomarkers are easily assessable and provide valuable information for cancer patients prognosis.…”

Section: Introductionmentioning

confidence: 99%

“…[3][4][5][6][7][8][9][10][11] Several routine complete blood count variables provide essential clues about different cancers types, such as neutrophil-to-lymphocyte ratio (NLR) and platelet-tolymphocyte ratio (PLR). 12,13 Such biomarkers are easily assessable and provide valuable information for cancer patients prognosis.…”

mentioning

confidence: 99%

The value of cellular components of blood in the setting of trimodal therapy for esophageal cancer

Tustumi

Takeda

Viyuela

et al. 2019

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Background Inflammation status plays an important role in the natural history of malignancy. Consequently, hematological markers of systemic inflammation may predict prognosis in neoplasms. This study evaluated the value of cellular blood components changes during neoadjuvant chemoradiotherapy followed by esophagectomy for cancer in predicting prognosis. Methods A cohort of 149 patients was analyzed. Cellular components of blood were assessed before neoadjuvant therapy (A); before surgery (B); and 3 to 5 months after surgery (C); for the following outcomes: pathological response, overall survival (OS), and disease‐free survival (DFS). Univariate and multivariate Cox regression models were applied to evaluate the independent prognostic significance of blood count variables. Results Low hematocrit (Ht) (C) (HR, 0.85; 95% CI, 0.79‐0.92) and high neutrophil‐to‐lymphocyte ratio (NLR) (C) (HR, 1.07; 95% CI, 1.07‐1.10) were related to poor OS. Low Hb (C) (HR, 0.72; 95% CI, 0.58‐0.88), red cell distribution width (RDW) (C‐A) (HR, 1.16; 95% CI, 1.02‐1.31), and NLR (C‐A) (1.06; 95% CI, 1.03‐1.09) were related to poor DFS. RDW (B‐A) (HR, 1.15; 95% CI, 1.08‐1.22), RDW (C) (HR, 1.12; 95% CI, 1.04‐1.2), NLR (C) (HR, 1.12; 95% CI, 1.08‐1.17) were related to systemic recurrence. Conclusion Variables of routine blood count are easily assessable and their changes throughout trimodal therapy for esophageal carcinoma provide important information for cancer patient's prognosis.