Glucose to Lymphocyte Ratio as a Prognostic Marker in Patients With Resected pT2 Gallbladder Cancer

Jonathan Navarro, Incheon Kang, Ho Kyoung Hwang, Dong Sup Yoon, Woo Jung Lee, Chang Moo Kang

Research output: Contribution to journalReview article

Abstract

Background: We designed a clinical application of glucose to lymphocyte ratio (GLR) as it might be a sensitive parameter to determine the glucose metabolism and behavior of the cancer (i.e., its aggressiveness), and the immunologic status of a patient with cancer. Thus, we investigated the association of GLR with the overall survival (OS) and disease-free survival (DFS) of patients with T2 gallbladder (GB) cancer after curative-intent surgery. Methods: The medical records of patients with T2 GB cancer who underwent surgery were retrospectively reviewed. The clinicopathologic characteristics, preoperative complete blood counts, fasting blood glucose, albumin, cholesterol, and follow-up information were collected. Results: A total of 197 patients were included in the study. In multivariate analysis, high GLR (>69.3) was associated with poor OS (HR = 15.249, 95% CI: 4.090-56.849, P = 0.0001) along with R1 status (HR = 1.755, 95% CI: 0.033-0.910, P = 0.033), >3 metastatic lymph nodes (HR = 2.809, 95% CI: 1.403-5.625; P = 0.004), and lymphovascular invasion (HR = 8.041, 95% CI: 2.881-22.442; P = 0.0001). Moreover, high GLR (HR = 3.666, 95% CI: 1.145-11.737, P = 0.029), adjuvant chemotherapy (HR = 6.306, 95% CI: 1.921-20.699; P = 0.002), lymphovascular invasion (HR = 5.464, 95% CI: 1.783-16.746; P = 0.003), and high-grade tumor (HR = 2.143, 95% CI: 1.042-4.407; P = 0.038) were independently associated with DFS. Conclusions: Preoperative GLR is an independent predictor of OS and DFS in T2 GB cancer. Further studies are required to validate these findings.

Original languageEnglish
Pages (from-to)17-29
Number of pages13
JournalJournal of Surgical Research
Volume240
DOIs
Publication statusPublished - 2019 Aug

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Gallbladder Neoplasms
Lymphocytes
Glucose
Disease-Free Survival
Survival
Neoplasms
Blood Cell Count
Adjuvant Chemotherapy
Medical Records
Blood Glucose
Albumins
Fasting
Multivariate Analysis
Lymph Nodes
Cholesterol

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Navarro, Jonathan ; Kang, Incheon ; Hwang, Ho Kyoung ; Yoon, Dong Sup ; Lee, Woo Jung ; Kang, Chang Moo. / Glucose to Lymphocyte Ratio as a Prognostic Marker in Patients With Resected pT2 Gallbladder Cancer. In: Journal of Surgical Research. 2019 ; Vol. 240. pp. 17-29.
@article{3bdb3e7dfae14b22814a25c19333496f,
title = "Glucose to Lymphocyte Ratio as a Prognostic Marker in Patients With Resected pT2 Gallbladder Cancer",
abstract = "Background: We designed a clinical application of glucose to lymphocyte ratio (GLR) as it might be a sensitive parameter to determine the glucose metabolism and behavior of the cancer (i.e., its aggressiveness), and the immunologic status of a patient with cancer. Thus, we investigated the association of GLR with the overall survival (OS) and disease-free survival (DFS) of patients with T2 gallbladder (GB) cancer after curative-intent surgery. Methods: The medical records of patients with T2 GB cancer who underwent surgery were retrospectively reviewed. The clinicopathologic characteristics, preoperative complete blood counts, fasting blood glucose, albumin, cholesterol, and follow-up information were collected. Results: A total of 197 patients were included in the study. In multivariate analysis, high GLR (>69.3) was associated with poor OS (HR = 15.249, 95{\%} CI: 4.090-56.849, P = 0.0001) along with R1 status (HR = 1.755, 95{\%} CI: 0.033-0.910, P = 0.033), >3 metastatic lymph nodes (HR = 2.809, 95{\%} CI: 1.403-5.625; P = 0.004), and lymphovascular invasion (HR = 8.041, 95{\%} CI: 2.881-22.442; P = 0.0001). Moreover, high GLR (HR = 3.666, 95{\%} CI: 1.145-11.737, P = 0.029), adjuvant chemotherapy (HR = 6.306, 95{\%} CI: 1.921-20.699; P = 0.002), lymphovascular invasion (HR = 5.464, 95{\%} CI: 1.783-16.746; P = 0.003), and high-grade tumor (HR = 2.143, 95{\%} CI: 1.042-4.407; P = 0.038) were independently associated with DFS. Conclusions: Preoperative GLR is an independent predictor of OS and DFS in T2 GB cancer. Further studies are required to validate these findings.",
author = "Jonathan Navarro and Incheon Kang and Hwang, {Ho Kyoung} and Yoon, {Dong Sup} and Lee, {Woo Jung} and Kang, {Chang Moo}",
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Glucose to Lymphocyte Ratio as a Prognostic Marker in Patients With Resected pT2 Gallbladder Cancer. / Navarro, Jonathan; Kang, Incheon; Hwang, Ho Kyoung; Yoon, Dong Sup; Lee, Woo Jung; Kang, Chang Moo.

In: Journal of Surgical Research, Vol. 240, 08.2019, p. 17-29.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Glucose to Lymphocyte Ratio as a Prognostic Marker in Patients With Resected pT2 Gallbladder Cancer

AU - Navarro, Jonathan

AU - Kang, Incheon

AU - Hwang, Ho Kyoung

AU - Yoon, Dong Sup

AU - Lee, Woo Jung

AU - Kang, Chang Moo

PY - 2019/8

Y1 - 2019/8

N2 - Background: We designed a clinical application of glucose to lymphocyte ratio (GLR) as it might be a sensitive parameter to determine the glucose metabolism and behavior of the cancer (i.e., its aggressiveness), and the immunologic status of a patient with cancer. Thus, we investigated the association of GLR with the overall survival (OS) and disease-free survival (DFS) of patients with T2 gallbladder (GB) cancer after curative-intent surgery. Methods: The medical records of patients with T2 GB cancer who underwent surgery were retrospectively reviewed. The clinicopathologic characteristics, preoperative complete blood counts, fasting blood glucose, albumin, cholesterol, and follow-up information were collected. Results: A total of 197 patients were included in the study. In multivariate analysis, high GLR (>69.3) was associated with poor OS (HR = 15.249, 95% CI: 4.090-56.849, P = 0.0001) along with R1 status (HR = 1.755, 95% CI: 0.033-0.910, P = 0.033), >3 metastatic lymph nodes (HR = 2.809, 95% CI: 1.403-5.625; P = 0.004), and lymphovascular invasion (HR = 8.041, 95% CI: 2.881-22.442; P = 0.0001). Moreover, high GLR (HR = 3.666, 95% CI: 1.145-11.737, P = 0.029), adjuvant chemotherapy (HR = 6.306, 95% CI: 1.921-20.699; P = 0.002), lymphovascular invasion (HR = 5.464, 95% CI: 1.783-16.746; P = 0.003), and high-grade tumor (HR = 2.143, 95% CI: 1.042-4.407; P = 0.038) were independently associated with DFS. Conclusions: Preoperative GLR is an independent predictor of OS and DFS in T2 GB cancer. Further studies are required to validate these findings.

AB - Background: We designed a clinical application of glucose to lymphocyte ratio (GLR) as it might be a sensitive parameter to determine the glucose metabolism and behavior of the cancer (i.e., its aggressiveness), and the immunologic status of a patient with cancer. Thus, we investigated the association of GLR with the overall survival (OS) and disease-free survival (DFS) of patients with T2 gallbladder (GB) cancer after curative-intent surgery. Methods: The medical records of patients with T2 GB cancer who underwent surgery were retrospectively reviewed. The clinicopathologic characteristics, preoperative complete blood counts, fasting blood glucose, albumin, cholesterol, and follow-up information were collected. Results: A total of 197 patients were included in the study. In multivariate analysis, high GLR (>69.3) was associated with poor OS (HR = 15.249, 95% CI: 4.090-56.849, P = 0.0001) along with R1 status (HR = 1.755, 95% CI: 0.033-0.910, P = 0.033), >3 metastatic lymph nodes (HR = 2.809, 95% CI: 1.403-5.625; P = 0.004), and lymphovascular invasion (HR = 8.041, 95% CI: 2.881-22.442; P = 0.0001). Moreover, high GLR (HR = 3.666, 95% CI: 1.145-11.737, P = 0.029), adjuvant chemotherapy (HR = 6.306, 95% CI: 1.921-20.699; P = 0.002), lymphovascular invasion (HR = 5.464, 95% CI: 1.783-16.746; P = 0.003), and high-grade tumor (HR = 2.143, 95% CI: 1.042-4.407; P = 0.038) were independently associated with DFS. Conclusions: Preoperative GLR is an independent predictor of OS and DFS in T2 GB cancer. Further studies are required to validate these findings.

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