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Neutrophil–lymphocyte Ratio and Histological Response Correlate With Prognosis of Gastric Cancer Undergoing Neoadjuvant Chemotherapy

Urakawa, Naoki Kanaji, Shingo Kato, Takashi Sawada, Ryuichiro Harada, Hitoshi Goto, Hironobu Hasegawa, Hiroshi Yamashita, Kimihiro Matsuda, Takeru Oshikiri, Taro Kakeji, Yoshihiro 神戸大学

2023.01

概要

Background/Aim: Neoadjuvant chemotherapy (NAC) for advanced gastric cancer (GC) and esophagogastric junction cancer (EGC) is expected to effectively control the tumor; however, histological tumor response and immune function markers as prognostic factors for NAC remain unknown. This study assessed the prognostic significance of histological response and immune function markers in patients undergoing NAC for GC and EGC. Patients and Methods: Forty-two patients who underwent NAC followed by surgical resection for operable advanced GC or EGC from January 2007 to December 2019 were divided into two groups based on histological response. Overall survival (OS), tumor response, and immune function markers, such as the neutrophil/lymphocyte ratio (NLR), were the outcomes analyzed. Results: The 5-year OS for Grade 2b-3 (n=10, responder group) according to the Japanese Gastric Cancer Classification was 72.0% with a favorable prognosis, compared with 33.3% for Grade 0-1a (n=18), and 46.8% for Grade 1b-2a (n=14) in the non-responder group. There was no significant difference in the background between the two groups regarding clinical status or immune function markers. In a multivariate analysis of immune function markers, the NLR value before NAC was significantly associated with prognosis (p=0.048). Patients with an NLR value <3.4 had a favorable OS (p=0.03). Conclusion: Histological response scores for Grade 2b or higher may help predict a favorable prognosis for patients undergoing NAC for advanced GC and EGC. The outcomes may be further improved by considering NLR values.

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参考文献

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Received November 29, 2022

Revised December 12, 2022

Accepted December 13, 2022

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