Postoperative ratio of the maximum C-reactive protein level to the minimum peripheral lymphocyte count as a prognostic indicator for gastric cancer patients

Surg Today. 2019 Mar;49(3):206-213. doi: 10.1007/s00595-018-1724-x. Epub 2018 Oct 13.

Abstract

Purpose: Inflammation, together with immune and nutritional status, are associated with the progression of various cancer types. We evaluated the prognostic significance of the postoperative ratio (post-CLR) of the maximum C-reactive protein value (post-CRPMax) to the minimum peripheral lymphocyte count (post-LCMin) in patients with gastric cancer (GC).

Methods: The subjects of this retrospective study were 227 patients who underwent curative surgery for histopathologically diagnosed gastric adenocarcinoma.

Results: The 5-year overall survival (OS) rates differed significantly between the post-CLRHigh (≥ 152.6) group and the post-CLRLow (< 152.6) group for all patients (45.0% vs. 68.4%, respectively; P < 0.001). The 5-year disease-specific survival (DSS) rates were also significantly related to post-CLR for all patients, (80.6% vs. 64.3% for the post-CLRLow and the post-CLRHigh groups, respectively; P = 0.002). Among patients without infectious complications, the CLR affected both the 5-year OS rate (48.4% vs. 69.2% for the post-CLRHigh and the post-CLRLow groups, respectively; P = 0.006) and the 5-year DSS rate (80.2% vs. 67.0% for the post-CLRLow and the post-CLRHigh groups, respectively; P = 0.027). Multivariate analysis revealed that post-CLR was an independent prognostic indicator for both the OS and DSS of all patients.

Conclusions: Our finding show that the post-CLR can help predict the prognosis of GC patients.

Keywords: CRP; Gastric cancer; Lymphocyte; Prognosis; Recurrence.

MeSH terms

  • Adenocarcinoma / diagnosis*
  • Adenocarcinoma / mortality
  • Adenocarcinoma / surgery
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / blood*
  • C-Reactive Protein / analysis*
  • Female
  • Hepatectomy
  • Humans
  • Lymphocyte Count*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Postoperative Period
  • Predictive Value of Tests
  • Prognosis
  • Retrospective Studies
  • Stomach Neoplasms / diagnosis*
  • Stomach Neoplasms / mortality
  • Stomach Neoplasms / surgery
  • Survival Rate

Substances

  • Biomarkers, Tumor
  • C-Reactive Protein