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Although the pretreatment absolute lymphocyte count (ALC) has been reported as a prognostic factor in gastric cancer patients, the impact of perioperative changes in the ALC remains unknown. The aim of the present study was to explore the relationship between surgery-induced lymphopenia and outcome.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Database entries for 584 patients who underwent curative resections for pathological Stage IB-III gastric cancer were reviewed. We retrospectively compared clinicopathological factors including pretreatment ALC (pre-ALC) and ALC at first visit after discharge (post-ALC) with the survival. The low ALC was defined as\u2009&lt;\u20091000\/\u03bcL.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The ALC decreased significantly at 1 and 3\u00a0days after surgery and then recovered to the baseline value. A low pre-ALC (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and a low post-ALC (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) were both correlated with a poor relapse-free survival (RFS). A multivariate analysis of RFS identified a low post-ALC (hazard ratio 1.875, 95% CI 1.156\u20133.402, <jats:italic>p<\/jats:italic>\u2009=\u20090.01), age, gender, BMI, T disease, N disease, severe vessel invasion, type of gastrectomy and postoperative morbidity as independent factors. The low post-ALC group had a poor RFS among patients with Stage II (<jats:italic>p<\/jats:italic>\u2009=\u20090.04) and Stage III (<jats:italic>p<\/jats:italic>\u2009=\u20090.04) disease, but not among patients with Stage IB disease (<jats:italic>p<\/jats:italic>\u2009=\u20090.13). Consistently, the overall survival (OS) rate was significantly lower among patients with a low post-ALC for all stage (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), stage II (<jats:italic>p<\/jats:italic>\u2009=\u20090.02) and stage III (<jats:italic>p<\/jats:italic>\u2009=\u20090.01) disease, not for stage IB (<jats:italic>p<\/jats:italic>\u2009=\u20090.09). A low post-ALC was identified as an independent factor for predicting OS by multivariate analysis (hazard ratio: 2.275, 95% CI 1.373\u20133.769, <jats:italic>p<\/jats:italic>\u2009=\u20090.01).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>A decrease in post-ALC was correlated with both of RFS and OS after curative resection in patients with locally advanced gastric cancer.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Highlights<\/jats:title>\n                <jats:p>Postoperative lymphopenia was a poor prognostic factor for gastric cancer.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12957-023-02887-0","type":"journal-article","created":{"date-parts":[[2023,1,16]],"date-time":"2023-01-16T05:02:49Z","timestamp":1673845369000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Predictive significance of surgery-induced lymphopenia on the survival after curative resection for locally advanced gastric cancer: a retrospective cohort analysis"],"prefix":"10.1186","volume":"21","author":[{"given":"Masaki","family":"Aizawa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Yabusaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Matsuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeo","family":"Bamba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoru","family":"Nakagawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,1,16]]},"reference":[{"key":"2887_CR1","doi-asserted-by":"publisher","first-page":"87","DOI":"10.3322\/caac.21262","volume":"65","author":"LA Torre","year":"2015","unstructured":"Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. 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The study was approved by the institutional review board of Niigata Cancer Center Hospital (2020\u2013231). Informed consent was obtained from all individual participants in the form of opt-out.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"This manuscript does not include any individual person\u2019s data in any form.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Drs. Masaki Aizawa, Hiroshi Yabusaki, Atsushi Matsuki, Takeo Bamba, and Satoru Nakagawa declare that they have no conflicts of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"7"}}