Erschienen in:
01.02.2018 | Original Scientific Report
Comprehensive Analysis of the Neutrophil-to-Lymphocyte Ratio for Preoperative Prognostic Prediction Nomogram in Gastric Cancer
verfasst von:
Jong-Ho Choi, Yun-Suhk Suh, Yunhee Choi, Jiyeon Han, Tae Han Kim, Shin-Hoo Park, Seong-Ho Kong, Hyuk-Joon Lee, Han-Kwang Yang
Erschienen in:
World Journal of Surgery
|
Ausgabe 8/2018
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Abstract
Background
The role of neutrophil-to-lymphocyte ratio (NLR) and preoperative prediction model in gastric cancer is controversial, while postoperative prognostic models are available. This study investigated NLR as a preoperative prognostic indicator in gastric cancer.
Methods
We reviewed patients with primary gastric cancer who underwent surgery during 2007–2010. Preoperative clinicopathologic factors were analyzed with their interaction and used to develop a prognosis prediction nomogram. That preoperative prediction nomogram was compared to a nomogram using pTNM or a historical postoperative prediction nomogram. The contribution of NLR to a preoperative nomogram was evaluated with integrated discrimination improvement (IDI).
Results
Using 2539 records, multivariable analysis revealed that NLR was one of the independent prognostic factors and had a significant interaction with only age among other preoperative factors (especially significant in patients < 50 years old). NLR was constantly significant between 1.1 and 3.1 without any distinctive cutoff value. Preoperative prediction nomogram using NLR showed a Harrell’s C-index of 0.79 and an R2 of 25.2%, which was comparable to the C-index of 0.78 and 0.82 and R2 of 26.6 and 25.8% from nomogram using pTNM and a historical postoperative prediction nomogram, respectively. IDI of NLR to nomogram in the overall population was 0.65%, and that of patients < 50 years old was 2.72%.
Conclusions
NLR is an independent prognostic factor for gastric cancer, especially in patients < 50 years old. A preoperative prediction nomogram using NLR can predict prognosis of gastric cancer as effectively as pTNM and a historical postoperative prediction nomogram.