Neutrophil to lymphocyte ratio as a prognostic marker in metastatic gallbladder cancer

Mohamed Mady, Kritika Prasai, Sri H. Tella, Siddhartha Yadav, Christopher L. Hallemeier, Sagar Rakshit, Lewis Roberts, Mitesh Borad, Amit Mahipal

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: Neutrophil-to-lymphocyte ratio (NLR) has been used as an inflammation based prognostic marker for various malignancies. This study evaluated the association between NLR and overall survival (OS) in patients with metastatic gallbladder cancer (GBC) Methods: An optimal cut off point for NLR was identified by plotting spline-based hazard ratio curves to identify a threshold effect and patients were divided into two groups, ≥5 or <5. Kaplan–Meier curves were plotted for NLR≥5 and NLR<5 and OS between the two groups. Results: Of the 231 patients included, 138 (60%) had NLR <5 and 93 (40%) had NLR ≥5. There were no significant differences noted in gender, race, and administration of chemotherapy between the two groups. On univariable analysis, patients with NLR ≥5 had a significantly poor OS compared to those with NLR <5 (Median OS: 3.6 vs 8.7 months, p < 0.001). On multivariable analysis, adjusting for age, performance status, albumin, alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, bilirubin, platelet count and no administration of chemotherapy, NLR of ≥5 was associated with a worse OS compared to NLR <5 (HR: 1.70, 95%CI:1.20–2.39, p < 0.05). Conclusion: The current study demonstrates that NLR ≥5 is an independent predictor of poor prognosis in patients with metastatic GBC.

Original languageEnglish (US)
Pages (from-to)1490-1495
Number of pages6
Issue number10
StatePublished - Oct 2020

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


Dive into the research topics of 'Neutrophil to lymphocyte ratio as a prognostic marker in metastatic gallbladder cancer'. Together they form a unique fingerprint.

Cite this