Neutrophil-lymphocyte ratio is prognostic in early stage resected small-cell lung cancer

Background: For selected early stage small cell lung cancer (SCLC), curative intent surgery is often performed. Previous studies, predominantly from East Asia, reported that high neutrophil to lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) correlate with poor prognosis in several types of tumors including SCLC. Our aim was to investigate the prognostic value of NLR and PLR in Caucasian patients with resected SCLC, as potential tool to select patients for multimodal treatment including surgery. Methods: Consecutive patients evaluated at three centers between 2000 and 2013 with histologically confirmed and surgically resected SCLC were retrospectively analyzed. NLR and PLR at diagnosis was used to categorize patients into "high" and "low" groups based on receiver operating curve analysis. Univariate and multivariate analyses were used to evaluate the impact of clinical and pathological characteristics on outcome. Results: There were a total of 189 patients with a median age of 58 years, and the majority had stage I or II disease. We found a significant correlation between NLR and tumor stage (p = 0.007) and age (p = 0.038). Low NLR (LNLR) was associated with significantly longer overall survival, while PLR had no prognostic impact. There were significant associations between NLR and PLR but not with gender, vascular involvement, tumor necrosis, peritumoral inflammation, or tumor grade. Conclusion: Pre-operative LNLR may be a favorable prognostic factor in stage I-II SCLCs. PLR is not prognostic in this population. LNLR is easy to assess and can be integrated into routine clinical practice. Further prospective studies are needed to confirm these observations. Copyright © 2019 Lohinai et al.

Lohinai Z.1, 2 , Bonanno L.3 , Aksarin A. 4 , Pavan A.3 , Megyesfalvi Z.1, 2 , Santa B.1 , Hollosi V.1 , Hegedus B.5 , Moldvay J.1 , Conte P.6 , Ter-Ovanesov M. 7 , Bilan E.1, 4 , Dome B.1, 2, 9 , Weiss G.J.10
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  • 1 National Koranyi Institute of Pulmonology, Budapest, Hungary
  • 2 Department of Thoracic Surgery, Semmelweis University and National Institute of Oncology, Budapest, Hungary
  • 3 Medical Oncology 2, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy
  • 4 Surgut District Clinical Hospital, Surgut, Russian Federation
  • 5 Department of Thoracic Surgery, University Hospital Essen, Essen, Germany
  • 6 Department of Surgical, Oncological and Gastroenterological Sciences, Università degli Studi di Padova, Padova, Italy
  • 7 Peoples' Friendship University of Russia, Moscow, Russian Federation
  • 8 Department of Oncology, Surgut District Clinical Hospital, Surgut, Russian Federation
  • 9 Division of Thoracic Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria
  • 10 Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
Ключевые слова
Early stage small cell lung cancer; Neutrophil-lymphocyte ratio; Platelet-lymphocyte ratio; Surgery
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