Otsuru T, et al. - In this retrospective chart review for 57 consecutive patients who had chemotherapy with GC (gemcitabine, cisplatin) for advanced biliary tract cancer (BTC), researchers investigated whether neutrophil/lymphocyte ratio (NLR) could be a prognostic factor associated with clinical outcomes. Excluded patients were those who were enrolled in ongoing clinical trials. At doses of 1,000 or 25 mg/m², gemcitabine and cisplatin were given intravenously on day one and eight, every three weeks. On the basis of estimated NLR, patients were grouped as those with NLR ≥ 3 (n=23) and those with NLR< 3 (n=34). Clinicopathological factors and survival were assessed in both groups. The features of the participants included median age, 68 years old (range: 38-83) years: male 36 (63%); primary tumor lesion, intrahepatic bile duct 6 (10%)/extrahepatic bile duct 32 (56%)/gallbladder 18 (32%)/ampulla of vater 1 (2%); therapeutic purpose, palliative 50 (88%)/adjuvant 5 (8%)/neoadjuvant 2 (4%); PS, 0/1. Overall, worse overall survival (OS) and PFS were observed in relation to high NLR, as corroborated in this study. Based on findings, high NLR could be a predictive marker for GC chemotherapy in patients with BTC.