Can we predict lymph node metastasis by using preoperative markers in gastric cancer patients

Introduction. Lymph node involvement is a negative prognostic factor for patients undergoing curative gastrectomy and indication for preoperative chemotherapy, thus a sufficient assessment strategy is required. We aimed to establish the value of preoperatively collected data in prediction of lymph node metastasis. Material and methods. We conducted a retrospective analysis of 150 gastric cancer patients hospitalized in the Department of Surgical Oncology, Medical University of Łodź in 2011–2017. We gathered information comprising clinicopathological features, inflammatory markers: neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), systemic inflammatory response index (SIRI) and Tumor Index (TI). Results. Independent factors associated with lymph node involvement were: NLR (OR = 1.35; p = 0.01), Tumor Index (OR = 1.07; p < 0.001). ROC curve plots assessed the diagnostic value of TI and NLR. Conclusions. Tumor Index and NLR are factors indicating lymph node metastasis in gastric cancer patients. NLR is a potentially useful tool for neoadjuvant chemotherapy qualification.

[1]  D. Cunningham,et al.  Gastric cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. , 2022, Annals of oncology : official journal of the European Society for Medical Oncology.

[2]  Jun Wu,et al.  A novel systemic inflammation response index (SIRI) for predicting postoperative survival of patients with esophageal squamous cell carcinoma , 2018, International immunopharmacology.

[3]  Yan Zhu,et al.  Prognostic significance of the infiltration of CD163+ macrophages combined with CD66b+ neutrophils in gastric cancer , 2018, Cancer medicine.

[4]  P. Yu,et al.  Interleukin-23 promotes the migration and invasion of gastric cancer cells by inducing epithelial-to-mesenchymal transition via the STAT3 pathway. , 2018, Biochemical and biophysical research communications.

[5]  P. Dong,et al.  Tumor-associated macrophages-derived exosomes promote the migration of gastric cancer cells by transfer of functional Apolipoprotein E , 2018, Cell Death & Disease.

[6]  M. Drews,et al.  Polish Consensus on Treatment of Gastric Cancer; update 2017. , 2017, Polski przeglad chirurgiczny.

[7]  X. Wan,et al.  Preoperative Monocyte-to-Lymphocyte Ratio in Peripheral Blood Predicts Stages, Metastasis, and Histological Grades in Patients with Ovarian Cancer12 , 2016, Translational oncology.

[8]  Zhihui Li,et al.  Association of the preoperative neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios with lymph node metastasis and recurrence in patients with medullary thyroid carcinoma , 2016, Medicine.

[9]  D. Ichikawa,et al.  Tumor Index as a Combined Indicator of Tumor Depth and Size in Gastric Cancer. , 2016, Anticancer research.

[10]  Wenyang Pang,et al.  Combination of preoperative platelet/lymphocyte and neutrophil/lymphocyte rates and tumor-related factors to predict lymph node metastasis in patients with gastric cancer , 2016, European journal of gastroenterology & hepatology.

[11]  Xinghua Gao,et al.  Can the Neutrophil to Lymphocyte Ratio Be Used to Determine Gastric Cancer Treatment Outcomes? A Systematic Review and Meta-Analysis , 2016, Disease markers.

[12]  S. Dong,et al.  Neoadjuvant chemotherapy in controlling lymph node metastasis for locally advanced gastric cancer in a Chinese population , 2016, Journal of chemotherapy.

[13]  I. Malanchi,et al.  Neutrophils support lung colonization of metastasis-initiating breast cancer cells , 2015, Nature.

[14]  A. Jemal,et al.  Global cancer statistics, 2012 , 2015, CA: a cancer journal for clinicians.

[15]  R. Schirren,et al.  Adjuvant and/or neoadjuvant therapy for gastric cancer? A perspective review , 2015, Therapeutic advances in medical oncology.

[16]  P. Rai,et al.  Techniques of imaging of nodal stations of gastric cancer by endoscopic ultrasound , 2014, Endoscopic ultrasound.

[17]  P. Kienle,et al.  Perioperative chemo(radio)therapy versus primary surgery for resectable adenocarcinoma of the stomach, gastroesophageal junction, and lower esophagus. , 2013, The Cochrane database of systematic reviews.

[18]  S. Mocellin,et al.  EUS for the staging of gastric cancer: a meta-analysis. , 2011, Gastrointestinal endoscopy.

[19]  P. Schlag,et al.  Neoadjuvant chemotherapy compared with surgery alone for locally advanced cancer of the stomach and cardia: European Organisation for Research and Treatment of Cancer randomized trial 40954. , 2010, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[20]  Yihong Sun,et al.  Neoadjuvant chemotherapy for advanced gastric cancer: a meta-analysis. , 2010, World journal of gastroenterology.

[21]  M. Karin,et al.  Immunity, Inflammation, and Cancer , 2010, Cell.

[22]  T. Kwee,et al.  Imaging in assessing lymph node status in gastric cancer , 2009, Gastric Cancer.

[23]  P. Allavena,et al.  Cancer-related inflammation , 2008, Nature.

[24]  John Condeelis,et al.  Macrophages: Obligate Partners for Tumor Cell Migration, Invasion, and Metastasis , 2006, Cell.

[25]  D. Reda,et al.  Watchful waiting vs repair of inguinal hernia in minimally symptomatic men: a randomized clinical trial. , 2006, JAMA.

[26]  B. Reiser,et al.  Estimation of the Youden Index and its Associated Cutoff Point , 2005, Biometrical journal. Biometrische Zeitschrift.

[27]  R. Schwarz.  Current Status of Management of Malignant Disease: Current Management of Gastric Cancer , 2015, Journal of Gastrointestinal Surgery.

[28]  R. Bhadra,et al.  NIH Public Access , 2014 .

[29]  J. Thigpen.  Perioperative Chemotherapy Compared With Surgery Alone for Resectable Gastroesophageal Adenocarcinoma: An FNCLCC and FFCD Multicenter Phase III Trial , 2011 .