Prediction of postoperative disease-free survival in gastric cancer patients using preoperative peripheral blood platelet-lymphocyte ratio: a retrospective study of 3392 patients from two centers

Abstract Background: Gastric cancer is one of the leading causes of cancer-related death, and postoperative recurrence in gastric cancer patients often indicates a poor prognosis. In recent years, biochemical composite indicators, such as peripheral blood platelet-lymphocyte ratio (PLR), have been found to predict recurrence and metastasis in various cancers. Methods: We retrospectively recruited patients who underwent radical gastrectomy for gastric cancer at Fudan University Affiliated Cancer Hospital from 2011 to 2019 and randomly divided them into training and internal validation groups. We calculated the relationship between clinical indicators, PLR, and gastric cancer recurrence and metastasis in the training group and validated the model in the internal validation group and Guangxi Medical University Affiliated Cancer Hospital. Results: The results of the multivariate analysis in the training group showed that TNM staging (HR, 3.69; 95% CI, 2.904.72; P<0.001), carcinoembryonic antigen (CEA) (HR, 1.44; 95% CI, 1.091.92; P<0.011), and peripheral blood PLR (HR, 1.43; 95% CI, 1.09~1.88; P<0.010) were independent risk factors for postoperative recurrence and metastasis in gastric cancer patients. The column chart model established based on independent risk factors showed a good predictive performance in the internal and external validation groups. Conclusions: Preoperative peripheral blood PLR is an independent risk factor for predicting postoperative recurrence and metastasis in gastric cancer patients, and the column chart model established by combining PLR with clinical indicators can accurately and efficiently predict postoperative recurrence and metastasis in gastric cancer patients.