Prognostic value of neutrophil-to-lymphocyte ratio in gastric cancer patients undergoing neoadjuvant chemotherapy: A systematic review and meta-analysis

Table 1 Baseline characteristics of the included literature

Ref.	Study period	Country	Study design	Time of test	Population	Neoadjuvant chemotherapy	Patients (n)	Gender		Age	NLR threshold
								Male	Female
Gong et al[13]	2007-2015	China	Retrospective	Before and after NAC	II-III	DOF, DF, FOLFOX	91	69	22	55	1.05
Jin et al[17]	2004-2009	China	Retrospective	Before and after NAC	III-IV	FOLFOX	46	36	10	60	2.50
el Aziz[19]	2010-2014	Egypt	Retrospective	Before NAC	III-IV	FOLFOX	70	47	23	53	3.00
Liu et al[15]	2016-2019	China	Retrospective	Before and after NAC	II-III	SOX, XELOX	111	83	28	58	1.75
Kasahara et al[20]	2011-2016	Japan	Retrospective	Before and after NAC	II	S-1	47	30	17	66	2.41
Chen et al[16]	2008-2015	China	Retrospective	Before NAC	II-III	SOX, XELOX	91	70	21	57	2.17
Zurlo et al[23]	2012-2017	Rome	Retrospective	Before and after NAC	III B-III C	XELOX, DOF	65	41	24	63	2.50
Pikuła et al[22]	2012-2020	Poland	Retrospective	Before and after NAC	II-III	EOX, FLOT-4	106	65	41	61	1.94
Li et al[21]	2014-2018	China	Prospective	Before and after NAC	II-IV A	DOF	225	172	53	60	2.57

NAC: Neoadjuvant chemotherapy; NLR: Neutrophil to lymphocyte ratio; DOF: Doxorubicin + oxaliplatin + fluorouracil; DF: Doxorubicin + fluorouracil; FOLFOX: Fluorouracil + oxaliplatin + calcium folinate; SOX: S-1 + oxaliplatin; XELOX: Oxaliplatin + capecitabine; S-1: Tegafur; EOX: Epirubicin + oxaliplatin + capecitabine; FLOT-4: Fluorouracil + oseltamivir + folinate + tegafur.

Table 2 Subgroup analysis of overall survival in patients with neoadjuvant chemotherapy for gastric cancer

Subgroup	OS
	Study	HR (95%CI)	P value	I2
Total	10	1.76 (1.22-2.54)	0.003	58%
Time of test
Pre-NAC	10	1.76 (1.22-2.54)	0.003	58%
Post-NAC	8	1.83 (1.22-2.75)	0.004	59%
Age
≥ 60 years	6	2.13 (1.24-3.67)	0.006	70%
< 60 years	4	1.40 (0.79-2.48)	0.25	37%
Region
Asia	6	1.36 (0.94-1.97)	0.1	37%
Africa	1	3.26 (1.14-9.28)	0.03	NA
Europe	3	2.36 (1.02-5.44)	0.04	65%
NLR cut-off
≥ 2	5	1.99 (1.01-3.94)	0.049	73%
< 2	5	1.65 (1.11-2.46)	0.01	12%

NAC: Neoadjuvant chemotherapy; NLR: Neutrophil to lymphocyte ratio; OS: Overall survival; HR: Hazard ratio; CI: Confidence interval.