Are pretreatment neutrophil-lymphocyte ratio and platelet-lymphocyte ratio useful in predicting the outcomes of patients with small-cell lung cancer?

Abstract

ObjectivesThe neutrophil-lymphocyte ratio (NLR) and the platelet-lymphocyte ratio (PLR) have been proved to affect the prognosis of various types of cancers. However, the prognostic role of NLR and PLR in patients with small-cell lung cancer (SCLC) remains controversial. The objective of this study is to assess the prognostic values of NLR, PLR and other potential prognostic indexes in SCLC patients.ResultsThe optimal cutoff levels were 2.65 for NLR, 125 for PLR and 210 for LDH by ROC curves analysis. Patients in the NLR ≥ 2.65 and LDH ≥ 210 groups were significantly correlated with worse PFS and OS. However, patients in the PLR < 125 group presented longer PFS time than patients in the PLR ≥ 125 group. Multivariate analysis showed that NLR ≥ 2.65 was an independent risk factor for both PFS (HR = 1.38; 95% CI 1.04–1.83; P = 0.027) and OS (HR = 1.35; 95% CI 1.02–1.79; P = 0.039). LDH and the clinical stage were independent prognostic factors for PFS in SCLC patients. LDH, surgery history, thoracic RT and PCI were independent prognostic factors for OS.Materials and Methods320 patients with SCLC were enrolled in this research from 2007 to 2014. Data was acquired through patients’ medical records and follow-ups. Receiver operating curve (ROC) was used to determine the optimal cut-off levels of NLR, PLR and lactate dehydrogenase (LDH). The Kaplan-Meier univariate analysis and multivariate Cox regression analysis were used to evaluate the impact of the NLR, PLR and other potential prognostic factors on overall survival (OS) and progressive-free survival (PFS).ConclusionsPretreatment elevated NLR and LDH were independent factors for poor prognosis in SCLC patients. High PLR was associated with poor PFS, but it was not an independent prognostic factor for PFS and OS.

Effect of Pretreatment Platelet Parameters on Survival in Limited Disease Small Cell Lung Cancer

“…Another study by Hong et al, (2018) among the 590 patients with LD-SCLC showed LDH, number of cycles of chemotherapy, and recurrence but not TPC as the independent factors affecting OS. Similarly, Deng et al performed a study with 320 Chinese patients (122 LD-SCLC and 198 ED-SCLC), where they reported pre-treatment increased LDH and NLR but not PLR as an independent poor prognostic factor (Deng et al, 2017). In our study, ECOG PS, clinical stage, PCI, and TPC were found to be independent factors affecting survival.…”

“…All other laboratory parameters including NLR, PLR, MLR, TLC, MPV, and PDW were not associated with OS. The majority of studies about SCLC were performed on Chinese patients, among which treated with CRT had a mOS 11.2 to 27.4 months (Hong et al, 2015;Xie et al, 2015;Deng et al, 2017;Liu et al, 2017;Hong et al, 2018;Zhang et al, 2019). In our study, mOS was found as 25 months in all patients, including 126 months in stage I or II and 19 months in stage III.…”

Incidence, Risk Factors, and Effect on Survival of Immune-related Adverse Events in Patients With Non–Small-cell Lung Cancer

“…20 The PLR was calculated as the ratio of platelets to absolute lymphocytes and was considered elevated if > 237 (median PLR). 17,18 Tumor mutation data were obtained as the routine standard of care at our Clinical Laboratory Improvement Amendments-certified molecular pathology laboratory.…”

“…5 was not associated with an increase in irAEs overall (P ¼ .94) or pneumonitis specifically (P ¼ . 18). An elevated PLR also did not correlate with the occurrence of irAEs (P ¼ .45) or pneumonitis (P ¼ .74), and an elevated ALI also was not associated with irAEs (P ¼ .80) or pneumonitis (P ¼ .17).…”

“…Cancer-associated inflammation has long been recognized as having a profound effect on survival, 13 and markers of systemic inflammation such as the neutrophil/lymphocyte ratio (NLR) have been found to be prognostic in large meta-analyses of all cancers 14 and NSCLC. 15,16 However, the ability of baseline markers of systemic inflammation, including the NLR, platelet/ lymphocyte ratio (PLR), 17,18 and advanced lung cancer inflammation index (ALI), 19,20 to predict irAEs has not been assessed.…”