TY - JOUR
T1 - Blood neutrophil-to-lymphocyte ratio is prognostic in gastrointestinal stromal tumor
AU - Perez, Daniel R.
AU - Baser, Raymond E.
AU - Cavnar, Michael J.
AU - Balachandran, Vinod P.
AU - Antonescu, Cristina R.
AU - Tap, William D.
AU - Strong, Vivian E.
AU - Brennan, Murray F.
AU - Coit, Daniel G.
AU - Singer, Samuel
AU - DeMatteo, Ronald P.
N1 - Funding Information:
ACKNOWLEDGMENT Supported in part by NIH Grant CA102613, the Geoffrey Beene Cancer Research Center, J. H. L. Pit and Mrs. Pit-van Karnebeek, and the Dutch GIST Foundation, GIST Cancer Research Fund, and Swim Across America (RPD).
PY - 2013/2
Y1 - 2013/2
N2 - Background: The immune system has been shown to play an important role in gastrointestinal stromal tumor (GIST). The neutrophil-to-lymphocyte ratio (NLR) in blood is an easily assessable parameter of systemic inflammatory response. The aim of this study was to determine whether the NLR is prognostic in GIST. Methods: A total of 339 previously untreated patients with primary, localized GIST operated at our institution between 1995 and 2010 were identified from a prospectively collected sarcoma database. NLR was assessed preoperatively. Patients who received adjuvant imatinib treatment were excluded from the analysis (n = 64). Cox regression models were calculated and correlation analyses were performed. Results: On univariate analysis, NLR was associated with recurrence-free survival (RFS) (P = 0.003, hazard ratio 3.3, 95 % confidence interval 1.5-7.4). Patients with a low NLR had a 1- and 5-year RFS of 98 and 91 %, compared with 89 and 76 % in those with a high NLR. The median RFS was not reached. Positive correlations were found between NLR and mitotic rate (Pearson correlation coefficient [r] = 0.15, P = 0.03), and NLR and tumor size (r = 0.36, P = 0.0001). RFS in patients with a GIST >5 cm with low NLR was significantly longer compared to patients with high NLR (P = 0.002). Flow cytometry analysis of freshly obtained GISTs revealed that neutrophils constituted a minimal percentage of intratumoral immune cells. Conclusions: NLR is a surrogate for high-risk tumor features. Elevated blood NLR appears to represent systemic inflammation in patients with high-risk GIST.
AB - Background: The immune system has been shown to play an important role in gastrointestinal stromal tumor (GIST). The neutrophil-to-lymphocyte ratio (NLR) in blood is an easily assessable parameter of systemic inflammatory response. The aim of this study was to determine whether the NLR is prognostic in GIST. Methods: A total of 339 previously untreated patients with primary, localized GIST operated at our institution between 1995 and 2010 were identified from a prospectively collected sarcoma database. NLR was assessed preoperatively. Patients who received adjuvant imatinib treatment were excluded from the analysis (n = 64). Cox regression models were calculated and correlation analyses were performed. Results: On univariate analysis, NLR was associated with recurrence-free survival (RFS) (P = 0.003, hazard ratio 3.3, 95 % confidence interval 1.5-7.4). Patients with a low NLR had a 1- and 5-year RFS of 98 and 91 %, compared with 89 and 76 % in those with a high NLR. The median RFS was not reached. Positive correlations were found between NLR and mitotic rate (Pearson correlation coefficient [r] = 0.15, P = 0.03), and NLR and tumor size (r = 0.36, P = 0.0001). RFS in patients with a GIST >5 cm with low NLR was significantly longer compared to patients with high NLR (P = 0.002). Flow cytometry analysis of freshly obtained GISTs revealed that neutrophils constituted a minimal percentage of intratumoral immune cells. Conclusions: NLR is a surrogate for high-risk tumor features. Elevated blood NLR appears to represent systemic inflammation in patients with high-risk GIST.
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U2 - 10.1245/s10434-012-2682-y
DO - 10.1245/s10434-012-2682-y
M3 - Article
C2 - 23054118
AN - SCOPUS:84876980317
SN - 1068-9265
VL - 20
SP - 593
EP - 599
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
IS - 2
ER -