Score of the preoperative absolute number of lymphocytes, monocytes, and neutrophils as a prognostic indicator for patients with gastric cancer

Purpose: The association between the preoperative absolute neutrophil count (NC), lymphocyte count (LC), and monocyte count (MC) in the peripheral blood and the prognosis of gastric cancer (GC) patients has not been investigated widely. Methods: We enrolled 445 patients who underwent surgery for GC between January, 2005 and April, 2013 to analyze the correlations among NC, LC, and MC and their prognoses. Results: Based on cut-off values calculated by ROC analysis, patients were sub grouped as having: NC ≥ 4477 (NC^High), NC < 4477 (NC^Low); and as LC ≥ 1447 (LC^High), LC < 1447 (LC^Low); and as MC ≥ 658.5 (MC^High), MC < 658.5 (MC^Low). Each group was assigned as follows; NC^High group = 1, NC^Low group = 0, LC^High group = 0, LC^Low group = 1, MC^High group = 1, MC^Low group = 0, and the sum of each score was defined as the lymphocyte–monocyte–neutrophil score (LMN score). The overall 5-year survival rates were 89%, 74%, 57.8%, and 53.3% for LMN scores of 0, 1, 2, and 3, respectively (P = 0.0004). Multivariate analysis indicated that the LMN score was an independent prognostic indicator. Conclusions: The combination of preoperative NC, LC, and MC appears to be a useful indicator of GC prognosis.