Impact of Platelet-Lymphocyte Ratio (PLR) in the prognosis of Gastric Cancer patients

Abstract

Background: Cancer-related inflammation is central in tumoral evolution. Elevated platelet-lymphocyte ratio (PLR), an inflammatory biomarker, has been reported as a prognostic predictor in Gastric Cancer (GC). The study's aim was to evaluate the effect of PLR in the prognosis of GC patients submitted to curative-intent resectional surgery. Methods: A retrospective analysis of a prospective database with 637 GC cases submitted to curative-intent surgery, between January 2010 and December 2017, in an Upper GI Surgery Unit. We analyzed 396 patients that met the inclusion criteria for this study. Results: In this cohort (n=359), PLR was significantly associated with DFS [HR=1,002; CI95%=1,000-1,004; p=0,015) and OS [HR=1,002; CI95%=1,001-1,004; p=0,004]. Regarding the ROC curve of PLR for OS, the AUC was 0,582 (CI95%=0,521-0,642; p=0,008). Using Youden's method, the optimal PLR cut-off for OS was 160,613. The high PLR (>160,613) group was associated with worse OS [HR=1,676; CI95%=1,221-2,300; p=0,001] and DFS [HR=1,665; CI95%=1,074-2,582; p=0,023]. There was a significant (p=0,043) association between PLR and postoperative complications [18,4% vs 27,5% in low and high PLR groups, respectively; OR=1,673; CI95%=1,015-2,758; p=0,044]. Conclusions: PLR was a prognostic factor in GC patients submitted to curative-intent resectional surgery. PLR>160,613 was associated with worse OS, DFS and more postoperative complications, in this cohort.