Prognostic value of neutrophil-to-lymphocyte ratio in advanced oesophago-gastric cancer: exploratory analysis of the REAL-2 trial

Annals of Oncology : Official Journal of the European Society for Medical Oncology
T GrenaderJ Bridgewater

Abstract

The REAL-2 trial demonstrated that capecitabine and oxaliplatin were effective alternatives to fluorouracil and cisplatin, respectively, when used in triplet chemotherapy regimens for previously untreated oesophago-gastric cancer. The aim of the current analysis was to evaluate the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) in the REAL-2 cohort. A post hoc exploratory analysis was carried out on REAL-2 patients with the available absolute neutrophil count and absolute lymphocyte count. A high NLR was defined using a cut-off value of >3.0. The NLR was then correlated with clinical outcomes including overall survival (OS), progression-free survival (PFS) and objective response rate. Survival curves were generated using the Kaplan-Meier method and comparison between groups was carried out using Cox regression. Data were available in 908 of the 1002 REAL-2 participants. Of these, 516 (56.8%) were deemed to have a high NLR. In univariate analysis, high NLR was associated with a hazard ratio (HR) for OS of 1.73 (1.50-2.00), P < 0.001, compared with low NLR, equating to median OS values of 9.1 [95% confidence interval (CI) 8.0-9.6] and 12.7 months (95% CI 10.8-14.4), respectively. The NLR remained highly significant ...Continue Reading

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Citations

Sep 19, 2016·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Melvin Lee Kiang ChuaTerence Wee Kiat Tan
Feb 17, 2017·Gastric Cancer : Official Journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association·Daisuke TakahariNarikazu Boku
Nov 5, 2019·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·S J M van HootegemA P Barbour
Dec 6, 2019·Frontiers in Oncology·Olga KersyGuy Lahat
May 16, 2020·Gastroenterology Research and Practice·Qingbin NiuBaoguang Hu
Mar 1, 2019·World Journal of Critical Care Medicine·Vishal H PatelHussein Othman
Jul 29, 2017·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Eva LietoVincenzo Napolitano
Feb 6, 2020·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Jian-Xian LinPing Li
Dec 7, 2017·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Hsin-Yu FangMichael Quante
Nov 5, 2019·The Journal of Surgical Research·Benjamin M HallSean Monaghan
Feb 11, 2021·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Hao ShenFeng Shen

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