Predictive Value of Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios for Distant Metastasis in Vietnamese Gastric Cancer Patients

Abstract Background Gastric cancer (GC) remains a leading cause of global cancer mortality, with a high prevalence of distant metastasis at diagnosis in Vietnam. Systemic inflammatory markers are emerging as potential tools for risk assessment, yet their independent predictive value in the Vietnamese population requires further clarification. Objective To evaluate the predictive value of the Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) as cost-effective biomarkers for distant metastasis in Vietnamese GC patients. Design A single-center, retrospective cohort study of 114 GC patients treated at the Oncology Hospital of Ho Chi Minh City between January and June 2023. Methods Patients were categorized into metastatic (Stage IV) and non-metastatic groups per AJCC 8th edition criteria. Pretreatment NLR and PLR were calculated from peripheral blood counts. The optimal cutoffs were determined using receiver operating characteristic (ROC) curve analysis. DeLong’s test was employed to compare the diagnostic efficacy of the clinical model versus the combined clinical-hematological model. Univariate and multivariate binary logistic regression analyses were performed to identify independent predictors of distant metastasis. Results Metastasis was present in 44.7% of cases. Optimal cutoffs of 2.0 for NLR and 181.5 for PLR were identified. Both markers were significantly higher in the metastatic group (p