Platelet-to-lymphocyte ratio and lymphocyte-to-white blood cell ratio predict the efficacy of neoadjuvant chemotherapy and the prognosis of locally advanced gastric cancer patients treated with the oxaliplatin and capecitabine regimen.

Background: Many studies have discussed the relationship between routine blood parameters and the prognosis of gastric cancer patients; however, few studies focused on the association of routine blood parameters with the efficacy of neoadjuvant chemotherapy (NAC).

Patients and methods: We retrospectively collected routine blood parameters and other clinicopathological data of 104 patients with locally advanced gastric cancer (LAGC) who received the oxaliplatin and capecitabine regimen as NAC from June 2010 to March 2016. The objective response rate (ORR), pathological remission rate (pRR), overall survival (OS), and time to recurrence (TTR) were analyzed through different statistical methods, such as Chi-squared test, log-rank test, logistic regression, and Cox regression.

Results: In the multivariate analysis, a high platelet-to-lymphocyte ratio (PLR) (≥130.7) predicted a low ORR (OR =5.927, 95% CI: 2.184-16.089) and a low pRR (OR =8.343, 95% CI: 2.178-31.962), while a high lymphocyte-to-white blood cell ratio (LWR) (≥0.228) independently predicted a high ORR (OR =0.118, 95% CI: 0.031-0.448) and a high pRR (OR =0.096, 95% CI: 0.021-0.426). High lymphocyte level (≥1.750×109 /L) was an independent predictor of long OS (HR =0.428, 95% CI: 0.190-0.964) and long TTR (HR =0.328, 95% CI: 0.156-0.690). High monocyte level (≥0.215×109 /L) was associated with a high pRR (OR =0.072, 95% CI: 0.008-0.636) and a long OS (HR = 0.506, 95% CI: 0.257-0.997).

Conclusion: In patients with LAGC treated with the oxaliplatin and capecitabine regimen as NAC, a low PLR (<130.7) and a high LWR (≥0.228) independently predicted a high ORR and pRR. High monocyte level (≥0.215×109 /L) was an independent predictor for a high pRR and long OS, while patients with high lymphocyte level (≥1.750×109 /L) tended to have a long OS and TTR.