AB62. Blood neutrophil-lymphocyte ratio predicts the survival pf neoadjuvant chemotherapy in gastric cancer

Background: The efficacy and safety of neoadjuvant chemotherapy in patients with advanced gastric cancer were still under verification. However, there are not accurate predictors of survival in these patients.

Methods: fifty patients were enrolled in this study, the neutrophil-lymphocyte ratio (NLR) was divided into two groups as high (>2.5) and low (≤2.5). Univariate analysis on progression-free survival (PFS) and overall survival (OS) were performed by Kaplan-Meier analysis and log-rank test, multivariate analysis was conducted by the Cox Proportional Hazards Regression Model. The changes of NLR before and after chemotherapy and the prognostic significance of the changes on survival were also evaluated.

Results: The univariate analysis showed that patients with high NLR before chemotherapy had a worse PFS and OS than those with low NLR (PFS, P=0.012; OS P=0.113), patients with high NLR before operation also had a worse PFS and OS (PFS, P=0.019; OS P=0.082), respectively. Multivariate analysis demonstrated that NLR before operation was independent prognostic factor on PFS, however, it has no independent prognostic significance on OS. Neoadjuvant chemotherapy normalized high NLR in 11 of 24 patients, and these 11 patients had better median PFS (P=0.003) and better median OS (P=0.042) than the 13 patients who had high NLR both before chemotherapy and operation.

Conclusions: The NLR may serve as a potential biomarker for survival prognosis in patients with advanced gastric cancer receiving neoadjuvant chemotherapy. Normalization of NLR indicates better outcomes.

Keywords: Gastric cancer; neoadjuvant chemotherapy; neutrophil-lymphocyte ratio; progression-free survival; overall survival