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KMID : 0371320120830060352
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Journal of the Korean Surgical Society
2012 Volume.83 No. 6 p.352 ~ p.359
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The effectiveness of postoperative neutrophils to lymphocytes ratio in predicting long-term recurrence after stomach cancer surgery
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Kim Yun-Hong
Choi Won-Joon
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Abstract
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Purpose: Immunosuppression is a characteristic of cancer recurrence after curative resection. The neutrophil to lymphocyte ratio (NL ratio) in peripheral blood is associated with immune function. However, it is not clear whether the postoperative NL ratio is a predictor for cancer relapse after resection. Thus, we investigated the effectiveness of the short-term postoperative NL ratio in the prediction of disease recurrence within 5 years after stomach cancer surgery by a retrospective chart review. Methods: Ninety-three patients with stomach cancer were enrolled. Significant risk factors for cancer recurrence were determined by multivariate Cox regression. Independent variables to increase the NL ratio to ＞7.7 by postoperative day (POD) 3 were examined by multivariate logistic regression analysis. Results: The 5-year risk of cancer recurrence after gastrectomy was 4.2 times higher for patients with a POD3 NL ratio of ＞7.7 (P = 0.005), 3.4 times higher for normal-weight patients compared with overweight patients (P = 0.008), and 20 times higher for stage III compared with stage 0 according to the tumor-node-metastasis cancer staging system (P = 0.003). The surgical duration (hours) increased the chance of high NL ratio ＞7.7 (odds ratio, 2.5; P = 0.006). Conclusion: The postoperative NL ratio, especially the POD3 NL ratio, predicts long-term recurrence after stomach cancer surgery.
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KEYWORD
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Immunosuppression, Lymphocyte, Neoplasm recurrence, Neutrophil
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