Prognostic value of neutrophil-to-lymphocyte ratio in gastric cancer: Enhancing clinical relevance

Abstract

Gastric cancer (GC) is a leading cause of cancer-related deaths, highlighting the need for reliable prognostic biomarkers to guide treatment. Wei et al’s systematic review and meta-analysis evaluates the neutrophil-to-lymphocyte ratio (NLR) as a potential biomarker for GC patients undergoing neoadjuvant chemotherapy. NLR is a simple and cost-effective measure of systemic inflammation that shows promise in predicting treatment response and survival outcomes, including overall survival and progression-free survival. However, variations in NLR thresholds and timing of measurements affect its accuracy and clinical utility. Moreover, the studies reviewed primarily involved Asian populations, which may limit the generalizability of the findings. To improve NLR’s clinical relevance, future research should focus on standardizing NLR thresholds, refining measurement timing, and incorporating additional inflammatory markers like platelet-to-lymphocyte ratio and Glasgow prognostic score. Addressing confounders and including diverse patient populations will help improve NLR’s reliability as a prognostic marker for GC.

Keywords: Gastric cancer; Inflammatory markers; Neoadjuvant chemotherapy; Neutrophil-to-lymphocyte ratio; Prognostic biomarker; Survival outcomes

Core Tip: The neutrophil-to-lymphocyte ratio (NLR) shows promise as a prognostic biomarker for gastric cancer, but its clinical use faces challenges, such as inconsistent cut-off values and unclear timing for measurement. Standardizing these factors, exploring additional inflammatory markers, and refining research methodologies will enhance NLR’s reliability and clinical utility in managing gastric cancer.