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Platelet-to-lymphocyte ratio and lymphocyte-to-white blood cell ratio predict the efficacy of neoadjuvant chemotherapy and the prognosis of locally advanced gastric cancer patients treated with the oxaliplatin and capecitabine regimen

Authors Tang C, Cheng X, Yu S, Wang Y, Hou J, Li Q, Shen Z, Liu T, Cui Y

Received 10 June 2018

Accepted for publication 14 September 2018

Published 17 October 2018 Volume 2018:11 Pages 7061—7075

DOI https://doi.org/10.2147/OTT.S176768

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Ms Justinn Cochran

Peer reviewer comments 2

Editor who approved publication: Dr XuYu Yang


Cheng Tang,1 Xi Cheng,1 Shan Yu,1 Yan Wang,1 Jun Hou,2 Qian Li,1 Zhenbin Shen,3 Tianshu Liu,1 Yuehong Cui1

1Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, China; 2Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China; 3Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China

Background: Many studies have discussed the relationship between routine blood parameters and the prognosis of gastric cancer patients; however, few studies focused on the association of routine blood parameters with the efficacy of neoadjuvant chemotherapy (NAC).
Patients and methods: We retrospectively collected routine blood parameters and other clinicopathological data of 104 patients with locally advanced gastric cancer (LAGC) who received the oxaliplatin and capecitabine regimen as NAC from June 2010 to March 2016. The objective response rate (ORR), pathological remission rate (pRR), overall survival (OS), and time to recurrence (TTR) were analyzed through different statistical methods, such as Chi-squared test, log-rank test, logistic regression, and Cox regression.
Results: In the multivariate analysis, a high platelet-to-lymphocyte ratio (PLR) (≥130.7) predicted a low ORR (OR =5.927, 95% CI: 2.184–16.089) and a low pRR (OR =8.343, 95% CI: 2.178–31.962), while a high lymphocyte-to-white blood cell ratio (LWR) (≥0.228) independently predicted a high ORR (OR =0.118, 95% CI: 0.031–0.448) and a high pRR (OR =0.096, 95% CI: 0.021–0.426). High lymphocyte level (≥1.750×109/L) was an independent predictor of long OS (HR =0.428, 95% CI: 0.190–0.964) and long TTR (HR =0.328, 95% CI: 0.156–0.690). High monocyte level (≥0.215×109/L) was associated with a high pRR (OR =0.072, 95% CI: 0.008–0.636) and a long OS (HR = 0.506, 95% CI: 0.257–0.997).
Conclusion: In patients with LAGC treated with the oxaliplatin and capecitabine regimen as NAC, a low PLR (<130.7) and a high LWR (≥0.228) independently predicted a high ORR and pRR. High monocyte level (≥0.215×109/L) was an independent predictor for a high pRR and long OS, while patients with high lymphocyte level (≥1.750×109/L) tended to have a long OS and TTR.

Keywords: chemotherapy, PLR, LWR, gastric cancer

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