***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective : In cancer patients , the balance between neutrophil ( N ) and lymphocyte ( L ) cell counts fluctuates with advancing disease . The objective of our study was to determine the prognostic implication s of the N/L ratio in the peripheral blood of gastric cancer patients . Methods : Study participants were identified from a prospect i ve cohort of patients with advanced gastric cancer in Japan ( n = 1,220 ) . Results : The median baseline N/L was 2.58 ( range , 0.63–12.7 ) . Univariate analysis revealed that patients with an N/L ≧2.5 ( n = 644 ) had a significantly poorer prognosis than those with an N/L < 2.5 ( n = 576 ; log rank test , p = 0.019 × 10–12 ) . The median survival times for these two groups were 239 ( 95 % confidence interval , CI , 217–251 days ) and 363 days ( 95 % CI , 334–406 days ) , respectively , while the 1-year survival rates were 30 ( 95 % CI , 26–34 % ) and 50 % ( 95 % CI , 45–54 % ) , respectively . A multivariate Cox model established a significant relationship between the N/L ratio and survival ( adjusted hazard ratio = 1.52 ; 95 % CI , 1.32–1.75 ; p = 0.077 × 10–8 ) . Conclusions : These results suggest that the N/L ratio is an independent prognostic factor in advanced gastric cancer . Measurement of this ratio may serve as a clinical ly accessible and useful biomarker for patient survival Background : The concept of the involvement of systemic inflammation in cancer progression and metastases has gained attraction within the past decade . C-reactive protein ( CRP ) , a non-specific blood-based marker of the systemic inflammatory response , has been associated with decreased survival in several cancer types . The aim of the present study was to vali date the prognostic value of pre-operative plasma CRP levels on clinical outcome in a large cohort of soft-tissue sarcoma ( STS ) patients . Methods : Three hundred and four STS patients , operated between 1998 and 2010 , were retrospectively evaluated .  CRP levels and the impact on cancer-specific survival ( CSS ) , disease-free survival ( DFS ) and overall survival ( OS ) were assessed using Kaplan – Meier curves and univariate as well as multivariate Cox proportional models . Additionally , we developed a nomogram by supplementing the plasma CRP level to the well-established Kattan nomogram and evaluated the improvement of predictive accuracy of this novel nomogram by applying calibration and Harrell ’s concordance index ( c-index ) . Results : An elevated plasma CRP level was significantly associated with established prognostic factors , including age , tumour grade , size and depth ( P<0.05 ) . In multivariate analysis , increased CRP levels were significantly associated with a poor outcome for CSS ( HR=2.05 ; 95 % CI=1.13–3.74 ; P=0.019 ) and DFS ( HR=1.88 ; 95 % CI=1.07–3.34 ; P=0.029 ) . The estimated c-index was 0.74 using the original Kattan nomogram and 0.77 when the plasma CRP level was added . Conclusion : An elevated pre-operative CRP level represents an independent prognostic factor that predicts poor prognosis and improves the predictive ability of the Kattan nomogram in STS patients . Our data suggest to further prospect ively vali date its potential utility for individual risk stratification and clinical management of STS patients The derived neutrophil to lymphocyte ratio ( dNLR ) has been proposed as an easily determinable prognostic factor for cancer patients , but the prognostic significance of the dNLR in hepatocellular carcinoma ( HCC ) has not been investigated . The present study aim ed to vali date the prognostic power of the NLR and dNLR in HCC patients undergoing transarterial chemoembolization ( TACE ) .  The data of 279 consecutive patients who underwent TACE for unresectable HBV-associated HCC between September 2009 and November 2011 at the Department of Hepatobiliary Surgery , Sun Yat-sen University Cancer Center ( Guangzhou , China ) were retrieved from a prospect i ve data base . The cut-off values for the NLR and dNLR were determined by receiver operating characteristic ( ROC ) analysis . The association between the NLR and dNLR and the clinicopathological characteristics and overall survival ( OS ) rates and times of patients was analyzed . The area under the curve ( AUC ) was calculated to evaluate the discriminatory ability of the NLR and dNLR . The median follow-up period was 446 days , the 1 , 2 and 3-year OS rates were 38.8 , 18.5 and 11.1 % respectively , and the median OS time was 264 days . The cut-off values were determined as 2.6 and 1.8 for the NLR and dNLR , respectively . The NLR and dNLR were each associated with patient age , presence of vascular invasion , tumor size , AST level and ALP level . Multivariate analysis showed that the NLR , dNLR , ALT level and AFP level were independent prognostic factors for OS . An elevated NLR or dNLR was associated with a poor prognosis ( P=0.001 and P=0.002 , respectively ) . The prognostic power of NLR [ AUC=0.539 ; 95 % confidence interval ( CI ) , 0.423–0.656 ] and dNLR ( AUC=0.522 ; 95 % CI , 0.406–0.638 ) was similar . Elevated dNLR predicted poor prognosis for patients with HBV-associated HCC undergoing TACE , with similar prognostic power to NLR . The dNLR may be used as an alternative to the NLR , as it is easily available and inexpensive 
    Output:
    
Conclusions Elevated preoperative NLR , PLR , and CRP are associated with poor prognosis in HCC patients treated with TACE .
These inflammatory indices may be convenient , accessible , affordable and dependable biomarkers with prognostic potential for HCC patients treated by TACE