Prognostic Significance of Pre- and Postoperative Lymphocyte Counts in Patients with Gastric Cancer

Hiroaki Saito, Yusuke Kono, Yuki Murakami, Yuji Shishido, Hirohiko Kuroda, Manabu Yamamoto, Yoji Fukumoto, Tomohiro Osaki, Keigo Ashida, Yoshiyuki Fujiwara

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)

Abstract

Background: Although preoperative lymphopenia is reportedly a prognostic factor in cancer patients, the association between postoperative lymphopenia and patient prognosis has not been widely studied. Methods: We enrolled 352 patients who underwent surgery for gastric cancer (GC) between January 2005 and April 2013 to analyze correlations among pre- and postoperative lymphocyte counts (LCs) and prognosis in GC patients. Results: Pre- and postoperative (obtained 1 day after surgery) LCs were significantly correlated (r = 0.496, p < 0.0001). Pre- and postoperative LCs of elderly patients were significantly lower than those of non-elderly patients. Postoperative lymphocyte count was significantly lower in patients with a differentiated tumor than in those with an undifferentiated tumor. Based on the results of receiver operating characteristic analysis, patients were classified into subgroups as: preoperative LC ≥1,676 (pre-LC High ), preoperative LC <1,676 (pre-LC Low ); and as postoperative LC ≥855 (post-LC High ), and postoperative LC <855 (post-LC Low ). Five-year overall survival rates significantly differed between pre-LC High (82.5%) and pre-LC Low (71.6%) groups (p = 0.023); and also between the post-LC High (81.5%) and post-LC Low (69.5%) groups (p = 0.0072). The 5-year disease specific survival rates were 91.3 and 82.4% in patients with post-LC High and those with post-LC Low , respectively, and differences were statistically significant (p = 0.015). Multivariate analysis indicated that postoperative lymphocyte count was an independent prognostic indicator, along with age, gender, tumor size, lymph node metastasis, and venous invasion. Conclusions: Postoperative lymphocyte count is a useful predictive factor for prognosis in GC patients.

Original languageEnglish
Pages (from-to)137-143
Number of pages7
JournalDigestive Surgery
Volume36
Issue number2
DOIs
Publication statusPublished - 01-02-2019
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Gastroenterology

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