Preoperative monocyte-to-lymphocyte ratio predicts recurrence in gastrointestinal stromal tumors

Ferdinando Carlo Maria Cananzi, Eleonora Maddalena Minerva, Laura Samà, Laura Ruspi, Federico Sicoli, Lorenzo Conti, Uberto Fumagalli Romario, Vittorio Lorenzo Quagliuolo

Research output: Contribution to journalArticle

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Abstract

Background and Objectives: Several inflammation markers were found to have a prognostic value in cancer. We investigated the significance of preoperative white cell ratios in determining gastrointestinal stromal tumors (GISTs) outcome. Methods: Clinicopathological features of patients who underwent surgery for GIST were reviewed. The following peripheral blood inflammation markers were calculated: neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), platelet-lymphocyte ratio (PLR), neutrophil-white blood cell ratio (NWR), lymphocyte-white cell ratio (LWR), monocyte-white cell ratio (MWR), and platelet-white cell ratio (PWR). Results: We analyzed 127 patients. Three- and five-year disease-free survival (DFS) were 89.7% and 86.9%, respectively. The univariate analysis selected tumor diameter (P = 0.003), gastric location (P = 0.024), cell type (P = 0.024), mitosis (P < 0.001), MLR (P = 0.014), NLR (P = 0.016), and PLR (P = 0.001) as the factors associated to DFS. The independent prognostic factors for DFS were mitosis (P = 0.001), NLR (P = 0.015), MLR (P = 0.015), and PLR (P = 0.031), with MLR showing the highest statistical significance and hazard ratio (HR) value. MLR, NLR, and PLR were the only prognostic factors in the subgroup of patients with moderate to high Miettinen's risk class. A high value of MLR was associated with reduced DFS. Conclusion: MLR, NLR, and PLR are independent prognostic factors for DFS in GISTs. We first demonstrated the role of MLR as a predictor of recurrence in GIST. Its inclusion into clinical management may improve the recurrence estimation.

Original languageEnglish
Pages (from-to)12-20
Number of pages9
JournalJournal of Surgical Oncology
Volume119
Issue number1
DOIs
Publication statusPublished - Jan 1 2019

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Gastrointestinal Stromal Tumors
Monocytes
Lymphocytes
Recurrence
Neutrophils
Blood Platelets
Disease-Free Survival
Mitosis
Inflammation

Keywords

  • gastrointestinal stromal tumors
  • inflammation markers
  • monocyte-to-lymphocyte ratio
  • recurrence
  • surgery

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Preoperative monocyte-to-lymphocyte ratio predicts recurrence in gastrointestinal stromal tumors. / Cananzi, Ferdinando Carlo Maria; Minerva, Eleonora Maddalena; Samà, Laura; Ruspi, Laura; Sicoli, Federico; Conti, Lorenzo; Fumagalli Romario, Uberto; Quagliuolo, Vittorio Lorenzo.

In: Journal of Surgical Oncology, Vol. 119, No. 1, 01.01.2019, p. 12-20.

Research output: Contribution to journalArticle

Cananzi, Ferdinando Carlo Maria ; Minerva, Eleonora Maddalena ; Samà, Laura ; Ruspi, Laura ; Sicoli, Federico ; Conti, Lorenzo ; Fumagalli Romario, Uberto ; Quagliuolo, Vittorio Lorenzo. / Preoperative monocyte-to-lymphocyte ratio predicts recurrence in gastrointestinal stromal tumors. In: Journal of Surgical Oncology. 2019 ; Vol. 119, No. 1. pp. 12-20.
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abstract = "Background and Objectives: Several inflammation markers were found to have a prognostic value in cancer. We investigated the significance of preoperative white cell ratios in determining gastrointestinal stromal tumors (GISTs) outcome. Methods: Clinicopathological features of patients who underwent surgery for GIST were reviewed. The following peripheral blood inflammation markers were calculated: neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), platelet-lymphocyte ratio (PLR), neutrophil-white blood cell ratio (NWR), lymphocyte-white cell ratio (LWR), monocyte-white cell ratio (MWR), and platelet-white cell ratio (PWR). Results: We analyzed 127 patients. Three- and five-year disease-free survival (DFS) were 89.7{\%} and 86.9{\%}, respectively. The univariate analysis selected tumor diameter (P = 0.003), gastric location (P = 0.024), cell type (P = 0.024), mitosis (P < 0.001), MLR (P = 0.014), NLR (P = 0.016), and PLR (P = 0.001) as the factors associated to DFS. The independent prognostic factors for DFS were mitosis (P = 0.001), NLR (P = 0.015), MLR (P = 0.015), and PLR (P = 0.031), with MLR showing the highest statistical significance and hazard ratio (HR) value. MLR, NLR, and PLR were the only prognostic factors in the subgroup of patients with moderate to high Miettinen's risk class. A high value of MLR was associated with reduced DFS. Conclusion: MLR, NLR, and PLR are independent prognostic factors for DFS in GISTs. We first demonstrated the role of MLR as a predictor of recurrence in GIST. Its inclusion into clinical management may improve the recurrence estimation.",
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T1 - Preoperative monocyte-to-lymphocyte ratio predicts recurrence in gastrointestinal stromal tumors

AU - Cananzi, Ferdinando Carlo Maria

AU - Minerva, Eleonora Maddalena

AU - Samà, Laura

AU - Ruspi, Laura

AU - Sicoli, Federico

AU - Conti, Lorenzo

AU - Fumagalli Romario, Uberto

AU - Quagliuolo, Vittorio Lorenzo

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AB - Background and Objectives: Several inflammation markers were found to have a prognostic value in cancer. We investigated the significance of preoperative white cell ratios in determining gastrointestinal stromal tumors (GISTs) outcome. Methods: Clinicopathological features of patients who underwent surgery for GIST were reviewed. The following peripheral blood inflammation markers were calculated: neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), platelet-lymphocyte ratio (PLR), neutrophil-white blood cell ratio (NWR), lymphocyte-white cell ratio (LWR), monocyte-white cell ratio (MWR), and platelet-white cell ratio (PWR). Results: We analyzed 127 patients. Three- and five-year disease-free survival (DFS) were 89.7% and 86.9%, respectively. The univariate analysis selected tumor diameter (P = 0.003), gastric location (P = 0.024), cell type (P = 0.024), mitosis (P < 0.001), MLR (P = 0.014), NLR (P = 0.016), and PLR (P = 0.001) as the factors associated to DFS. The independent prognostic factors for DFS were mitosis (P = 0.001), NLR (P = 0.015), MLR (P = 0.015), and PLR (P = 0.031), with MLR showing the highest statistical significance and hazard ratio (HR) value. MLR, NLR, and PLR were the only prognostic factors in the subgroup of patients with moderate to high Miettinen's risk class. A high value of MLR was associated with reduced DFS. Conclusion: MLR, NLR, and PLR are independent prognostic factors for DFS in GISTs. We first demonstrated the role of MLR as a predictor of recurrence in GIST. Its inclusion into clinical management may improve the recurrence estimation.

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KW - monocyte-to-lymphocyte ratio

KW - recurrence

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