The value of pretreatment glucose-to-lymphocyte ratio for predicting survival of metastatic gastric cancer

Abstract

Aim: To demonstrate the prognostic importance of glucose-to-lymphocyte ratio (GLR) in metastatic gastric cancer (mGC). Methods: Retrospectively, 159 mGC patients were enrolled. Kaplan–Meier curve and Cox regression analysis were used to determine the prognostic value of the systemic immune inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), prognostic nutritional index (PNI) and GLR. Results: Progression-free survival (PFS) and overall survival (OS) were associated with NLR, PNI, SII and GLR by univariate analysis. Moreover, OS was associated with Eastern Cooperative Oncology Group performance status and the chemotherapy regimen. In multivariate analysis, only GLR was found to be independently prognostic for both PFS and OS. Conclusion: In mGC, GLR may be a new prognostic marker for both OS and PFS.

Plain language summary

Gastric cancer (GC) is the fourthcause of cancer-related deaths. Although different treatment algorithms, including immunotherapy, are applied in patients with unresectable or disseminated (metastatic) GC (mGC), survival results are not yet at the desired level. Different markers are being investigated to measure the response of cancer to treatment in these patients. Many studies have been conducted in this direction with the thought that the prognosis of these cancers will be affected by the patient’s own immune response and nutritional status. Despite this, standard markers have not been established to predict cancer-related survival. Studies have shown a relationship between GC and glucose metabolism processes. Recently, a fasting blood glucose-to-lymphocyte count ratio (GLR) marker was developed that simultaneously evaluates both glucose metabolism and the patient’s immune response. GLR was found to be effective in predicting survival time in cancers such as gallbladder cancer and hepatocellular carcinoma. However, the effect of GLR on survival in mGC is unclear. In this study, the authors investigated the prognostic significance of GLR in mGC. They found that low GLR was associated with longer survival in mGC. GLR may be a prognostic marker for survival in patients with mGC.

Tweetable abstract

In this retrospective study, the glucose-to-lymphocyte ratio was prognostic for metastatic gastric cancer survival. Lower glucose-to-lymphocyte ratio levels indicate longer survival.

Keywords::

• gastric cancer
• glucose
• lymphocyte
• prognosis

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending or royalties.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.