The role of postoperative neutrophil-to-lymphocyte ratio as a predictor of postoperative major complications following total gastrectomy for gastric cancer

• Published in: Annals of surgical treatment and research Vol. 103; no. 3; pp. 153 - 159
• Main Authors: Kwak, Jae Seung, Kim, Sung Gon, Lee, Sang Eok, Choi, Won Jun, Yoon, Dae Sung, Choi, In Seok, Moon, Ju Ik, Sung, Nak Song, Kwon, Seong Uk, Bae, In Eui, Lee, Seung Jae, Roh, Seung Jae
• Format: Journal Article
• Language: English
• Published: 대한외과학회 01.09.2022; The Korean Surgical Society
• Subjects: Original; 일반외과학; Biomarkers; Gastrectomy; Postoperative complications; Stomach neoplasms
• ISSN: 2288-6575; 2288-6796
• DOI: 10.4174/astr.2022.103.3.153

PurposeThis study was performed to investigate the role of the perioperative neutrophil-to-lymphocyte ratio (NLR) as an early predictor of major postoperative complications after total gastrectomy for gastric cancer. MethodsThis single-center, retrospective study reviewed consecutive patients with gastric cancer who underwent total gastrectomy at a single institution from March 2009 to March 2021. The postoperative complications were graded according to the Clavien-Dindo classification. We analyzed the patient demographics and surgical outcomes according to the grade of postoperative complications in the major complications group (≥grade III) and the no major complications group (<grade III and no complication). Laboratory tests were performed preoperatively and on postoperative days (POD) 2 and 5 to determine the NLR. ResultsOut of 212 patients (mean age, 64.1 years; 152 male [71.7%]), 63 (29.7%) underwent minimally invasive surgery. Twenty-five (11.8%) were in the major complications group and 187 (88.2%) were in the no major complications group. There was a significant difference in the NLR on POD 2 (16.54 vs. 8.83, P = 0.033) between the 2 groups. According to the receiver operating characteristic curve for the NLR on POD 2, the cutoff was calculated to be 9.6. In multivariate analysis, an NLR on POD 2 of ≥9.6 and an American Society of Anesthesiologists physical status classification of ≥III were statistically significant predictors of major postoperative complications. ConclusionDetermination of the NLR on POD 2 is a simple and useful method for the early prediction of major complications after total gastrectomy for gastric cancer.