Elevated Neutrophil-to-Lymphocyte Ratio Predicts Survival in Patients with Advanced Gastric Cancer Treated with Trastuzumab Combination Chemotherapy

Anticancer Res. 2018 May;38(5):3151-3156. doi: 10.21873/anticanres.12578.

Abstract

Background/aim: This study investigated the clinical prognostic relevance of the neutrophil-to-lymphocyte ratio (NLR) in patients with human epidermal receptor 2 (HER2)-positive metastatic advanced gastric cancer (AGC) treated with combination chemotherapy including trastuzumab.

Patients and methods: This is a retrospective analysis of 73 patients diagnosed with metastatic AGC who were treated with trastuzumab combination chemotherapy. NLR was calculated as the neutrophil count divided by the lymphocyte count. A cut-off value of 3 was selected, which classified patients into two categories, low (≤3.0) or high (>3.0).

Results: In the univariate analysis, the high-NLR patients showed a significantly shorter progression-free survival (PFS) and overall survival (OS) than the low-NLR patients (PFS, p=0.012, OS, p=0.047). In the multivariate analysis, the high NLR was independently associated with a shorter PFS (p=0.015) and OS (p=0.040).

Conclusion: This study found that a high NLR was associated with a shorter PFS and OS in patients with HER2-positive gastric cancer treated with trastuzumab.

Keywords: Gastric cancer; neutrophil-to-lymphocyte ratio; prognostic factor; trastuzumab.

MeSH terms

  • Adenocarcinoma / blood*
  • Adenocarcinoma / drug therapy*
  • Adenocarcinoma / mortality
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biomarkers, Tumor / blood*
  • Disease-Free Survival
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Lymphocyte Count
  • Male
  • Middle Aged
  • Neutrophils
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Stomach Neoplasms / blood*
  • Stomach Neoplasms / drug therapy*
  • Stomach Neoplasms / mortality
  • Trastuzumab / administration & dosage
  • Young Adult

Substances

  • Biomarkers, Tumor
  • Trastuzumab