The Preoperative Neutrophil-Lymphocyte Ratio Predicts Recurrence and Survival Among Patients Undergoing R0 Resections of Adenocarcinomas of the Esophagogastric Junction

Background and ObjectivesElevated preoperative neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) predict survival rates among patients with several types of cancer. The current study sought to clarify whether NLR and PLR are clinically useful independent prognostic indicators of adenocarcinomas of the esophagogastric junction (AEG) among patients undergoing curative resections (i.e., R0 resections). MethodsA total of 327 patients who underwent R0 resections for AEG were enrolled in the study. Data concerning demographic parameters, laboratory analyses, histopathology, and survival time were collected and analyzed. ResultsA total of 123 patients (37.6%) had elevated preoperative NLR (5). The median follow-up duration was 24.7 months (range=2-39 months). NLR was significantly related to histology (P=0.035), pTNM stage (P<0.0001) and tumor recurrence (P=0.022). Univariate analyses revealed that NLR were significantly associated with disease-free survival (DFS) and overall survival (OS; both P<0.0001). Multivariable analyses revealed that elevated NLR independently predicted poorer DFS (hazard ratio [HR]=2.551, P<0.0001) and OS (HR=2.743, P<0.0001). However, PLR did not significantly predict DFS or OS. ConclusionThe present study indicates that elevated preoperative NLR (5) is a useful marker of tumor recurrence and independently predicts poorer disease-free and overall survival among patients with AEG undergoing R0 resections. J. Surg. Oncol. 2014 110:333-340. (c) 2014 Wiley Periodicals, Inc.