Prognostic value of perioperative leukocyte count in resectable gastric cancer.

Abstract:

AIM:To investigate the prognostic significance of perioperative leukopenia in patients with resected gastric cancer. METHODS:A total of 614 eligible gastric cancer patients who underwent curative D2 gastrectomy and adjuvant chemotherapy were enrolled in this study. The relationship between pre- and postoperative hematologic parameters and overall survival was assessed statistically, adjusted for known prognostic factors. RESULTS:The mean white blood cell count (WBC) significantly decreased after surgery, and 107/614 (17.4%) patients developed p-leukopenia, which was defined as a preoperative WBC ≥ 4.0 × 10(9)/L and postoperative WBC < 4.0 × 10(9)/L, with an absolute decrease ≥ 0.5 × 10(9)/L. The neutrophil count decreased significantly more than the lymphocyte count. P-leukopenia significantly correlated with poor tumor differentiation and preoperative WBC. A higher preoperative WBC and p-leukopenia were independent negative prognostic factors for survival [hazard ratio (HR) = 1.602, 95% confidence interval (CI): 1.185-2.165; P = 0.002, and HR = 1.478, 95%CI: 1.149-1.902; P = 0.002, respectively] after adjusting for histology, Borrmann type, pTNM stage, vascular or neural invasion, gastrectomy method, resection margins, chemotherapy regimens, and preoperative WBC count. The patients with both higher preoperative WBC and p-leukopenia had a worse prognosis compared to those with lower baseline WBC and no p-leukopenia (27.5 mo vs 57.3 mo, P < 0.001). CONCLUSION:Preoperative leukocytosis alone or in combination with postoperative leukopenia could be independent prognostic factors for survival in patients with resectable gastric cancer.

journal_name

World J Gastroenterol

authors

Chen XF,Qian J,Pei D,Zhou C,Røe OD,Zhu F,He SH,Qian YY,Zhou Y,Xu J,Xu J,Li X,Ping GQ,Liu YQ,Wang P,Guo RH,Shu YQ

doi

10.3748/wjg.v22.i9.2818

subject

Has Abstract

pub_date

2016-03-07 00:00:00

pages

2818-27

issue

9

eissn

1007-9327

issn

2219-2840

journal_volume

22

pub_type

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