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Pretreatment neutrophil-to-lymphocyte ratio as a survival predictor for small-cell lung cancer

View Article: PubMed Central - PubMed

ABSTRACT

Background: The inflammatory response indexes, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), have prognostic value for a variety of cancers. However, their prognostic value for small-cell lung cancer (SCLC) has been rarely reported. In this study, we monitored changes of NLR and PLR along with the clinical outcomes in patients with limited-stage and extensive-stage SCLC who received standard treatments.

Materials and methods: We retrospectively reviewed the records of 153 patients who were pathologically diagnosed with SCLC and collected their hematological data at different time points during disease and treatment process. Kaplan–Meier analysis and Cox proportional hazards models were used to determine the prognostic significance of NLR and PLR for overall survival (OS) and progression-free survival (PFS).

Results: The median OS and PFS for all patients were 23.3 months and 11.0 months, respectively. After applying cutoffs of 3.2 for NLR and 122.7 for PLR, NLR, but not PLR, showed independent prognostic significance. High-NLR group was associated with shorter median OS (high vs low, 18.0 months vs 31.0 months, P<0.01) and shorter PFS (high vs low, 9.3 months vs 13.0 months, P=0.006). The cumulative 3-year OS rate and 3-year PFS rate of high-NLR group versus low-NLR group were 14.3% versus 37.3% and 8.6% versus 22.9%, respectively. In the multivariate analysis, both disease stage and NLR at diagnosis were independent prognostic factors for OS and PFS.

Conclusion: The NLR at diagnosis showed significant prognostic value for clinical outcomes in SCLC patients treated with chemoradiotherapy. As an effective biomarker of host immune status, NLR could potentially help monitoring disease progression and adjusting treatment plans.

No MeSH data available.


Related in: MedlinePlus

Survival for SCLC patients according to NLR and PLR stratification.Notes: (A) OS according to NLR. Solid blue – NLR <3.2, solid green – NLR ≥3.2. (B) PFS according to NLR. Solid blue – NLR <3.2, solid green – NLR ≥3.2. (C) OS according to PLR. Solid blue – PLR <122.7, solid green – PLR ≥122.7. (D) PFS according to PLR. Solid blue – PLR <122.7, solid green – PLR ≥122.7.Abbreviations: SCLC, small-cell lung cancer; NLR, neutrophil-to-lymphocyte ratio; PLR, platelet-to-lymphocyte ratio; OS, overall survival; PFS, progression-free survival.
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f1-ott-9-5761: Survival for SCLC patients according to NLR and PLR stratification.Notes: (A) OS according to NLR. Solid blue – NLR <3.2, solid green – NLR ≥3.2. (B) PFS according to NLR. Solid blue – NLR <3.2, solid green – NLR ≥3.2. (C) OS according to PLR. Solid blue – PLR <122.7, solid green – PLR ≥122.7. (D) PFS according to PLR. Solid blue – PLR <122.7, solid green – PLR ≥122.7.Abbreviations: SCLC, small-cell lung cancer; NLR, neutrophil-to-lymphocyte ratio; PLR, platelet-to-lymphocyte ratio; OS, overall survival; PFS, progression-free survival.

Mentions: The optimal cutoff values were 3.2 for NLR, with AUC of 0.723, and 122.7 for PLR, with AUC of 0.623. Based on these cutoff values, patients were stratified into two groups. Survival was analyzed using the Kaplan–Meier method with this stratification (Figure 1). The results showed that low-NLR group was significantly associated with better OS (low vs high, 31.0 months vs 18.0 months, P<0.01) and better PFS (low vs high, 13.0 months vs 9.3 months, P<0.01). The cumulative 3-year OS rates were 37.3% in low-NLR group and 14.3% in high-NLR group. The cumulative 3-year PFS rates were 22.9% in low-NLR group and 8.6% in high-NLR group. However, low-PLR group was significantly associated only with better OS (low vs high, 31.0 months vs 20.7 months, P=0.036). The cumulative 3-year OS rates were 36.8% in low-PLR group and 20.8% in high-PLR group.


Pretreatment neutrophil-to-lymphocyte ratio as a survival predictor for small-cell lung cancer
Survival for SCLC patients according to NLR and PLR stratification.Notes: (A) OS according to NLR. Solid blue – NLR <3.2, solid green – NLR ≥3.2. (B) PFS according to NLR. Solid blue – NLR <3.2, solid green – NLR ≥3.2. (C) OS according to PLR. Solid blue – PLR <122.7, solid green – PLR ≥122.7. (D) PFS according to PLR. Solid blue – PLR <122.7, solid green – PLR ≥122.7.Abbreviations: SCLC, small-cell lung cancer; NLR, neutrophil-to-lymphocyte ratio; PLR, platelet-to-lymphocyte ratio; OS, overall survival; PFS, progression-free survival.
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Related In: Results  -  Collection

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f1-ott-9-5761: Survival for SCLC patients according to NLR and PLR stratification.Notes: (A) OS according to NLR. Solid blue – NLR <3.2, solid green – NLR ≥3.2. (B) PFS according to NLR. Solid blue – NLR <3.2, solid green – NLR ≥3.2. (C) OS according to PLR. Solid blue – PLR <122.7, solid green – PLR ≥122.7. (D) PFS according to PLR. Solid blue – PLR <122.7, solid green – PLR ≥122.7.Abbreviations: SCLC, small-cell lung cancer; NLR, neutrophil-to-lymphocyte ratio; PLR, platelet-to-lymphocyte ratio; OS, overall survival; PFS, progression-free survival.
Mentions: The optimal cutoff values were 3.2 for NLR, with AUC of 0.723, and 122.7 for PLR, with AUC of 0.623. Based on these cutoff values, patients were stratified into two groups. Survival was analyzed using the Kaplan–Meier method with this stratification (Figure 1). The results showed that low-NLR group was significantly associated with better OS (low vs high, 31.0 months vs 18.0 months, P<0.01) and better PFS (low vs high, 13.0 months vs 9.3 months, P<0.01). The cumulative 3-year OS rates were 37.3% in low-NLR group and 14.3% in high-NLR group. The cumulative 3-year PFS rates were 22.9% in low-NLR group and 8.6% in high-NLR group. However, low-PLR group was significantly associated only with better OS (low vs high, 31.0 months vs 20.7 months, P=0.036). The cumulative 3-year OS rates were 36.8% in low-PLR group and 20.8% in high-PLR group.

View Article: PubMed Central - PubMed

ABSTRACT

Background: The inflammatory response indexes, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), have prognostic value for a variety of cancers. However, their prognostic value for small-cell lung cancer (SCLC) has been rarely reported. In this study, we monitored changes of NLR and PLR along with the clinical outcomes in patients with limited-stage and extensive-stage SCLC who received standard treatments.

Materials and methods: We retrospectively reviewed the records of 153 patients who were pathologically diagnosed with SCLC and collected their hematological data at different time points during disease and treatment process. Kaplan&ndash;Meier analysis and Cox proportional hazards models were used to determine the prognostic significance of NLR and PLR for overall survival (OS) and progression-free survival (PFS).

Results: The median OS and PFS for all patients were 23.3 months and 11.0 months, respectively. After applying cutoffs of 3.2 for NLR and 122.7 for PLR, NLR, but not PLR, showed independent prognostic significance. High-NLR group was associated with shorter median OS (high vs low, 18.0 months vs 31.0 months, P&lt;0.01) and shorter PFS (high vs low, 9.3 months vs 13.0 months, P=0.006). The cumulative 3-year OS rate and 3-year PFS rate of high-NLR group versus low-NLR group were 14.3% versus 37.3% and 8.6% versus 22.9%, respectively. In the multivariate analysis, both disease stage and NLR at diagnosis were independent prognostic factors for OS and PFS.

Conclusion: The NLR at diagnosis showed significant prognostic value for clinical outcomes in SCLC patients treated with chemoradiotherapy. As an effective biomarker of host immune status, NLR could potentially help monitoring disease progression and adjusting treatment plans.

No MeSH data available.


Related in: MedlinePlus