Clinical implication of pretreatment neutrophil to lymphocyte ratio in soft tissue sarcoma

Idowu, Oluwaseyi Kayode; Ding, Qingqing; Taktak, Azzam; Chandrasekar, C. R.; Yin, Qudong

doi:10.3109/1354750x.2012.699554

Cited by 62 publications

(60 citation statements)

References 40 publications

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“…To the best of our knowledge, in STS patients, up to now a potential prognostic value have been only investigated for the N/L ratio. 21,22 Therefore, we evaluated the prognostic significance of other previously reported potentially prognostic cellular ratios including N/L ratio, L/M ratio and P/L ratio regarding three different endpoints on a large training set and to confirm the findings, on a large validation set. In general, before a prognostic parameter can be implemented into a clinical setting for patients' surveillance or recruitment strategies to adjuvant treatment modalities, an independent external validation is a prerequisite.…”

Section: Discussionmentioning

confidence: 87%

The lymphocyte/monocyte ratio predicts poor clinical outcome and improves the predictive accuracy in patients with soft tissue sarcomas

et al. 2014

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Increasing evidence indicates the involvement of inflammation and coagulation in cancer progression and metastases. Inflammatory biomarkers hold great promise for improving the predictive ability of existing prognostic tools in cancer patients. In the present study, we investigated several inflammatory indices with regard to their prognostic relevance for predicting clinical outcome in soft tissue sarcoma (STS) patients. Three hundred and forty STS patients were divided into a training set (n 5 170) and a validation set (n 5 170). Besides well-established clinico-pathological prognostic factors, we evaluated the prognostic value of the neutrophil/lymphocyte (N/L) ratio, the lymphocyte/monocyte (L/M) ratio and the platelet/lymphocyte (P/L) ratio using Kaplan-Meier curves and univariate as well as multivariate Cox regression models. Additionally, we developed a nomogram by supplementing the L/M ratio to the well-established Kattan nomogram and evaluated the predictive accuracy of this novel nomogram by applying calibration and Harrell's concordance index (c-index). In multivariate analysis, a low L/M ratio was significantly associated with decreased CSS and DFS (HR 5 0.41, 95% CI 5 0.18-0.97, p 5 0.043; HR 5 0.39, 95% CI 5 0.16-0.91, p 5 0.031, respectively) in the training set. Using the validation set for confirmation, we found also in multivariate analysis an independent value for CSS (HR 5 0.33, 95% CI 5 0.12-0.90, p 5 0.03) and for DFS (HR 5 0.36, 95% CI 5 0.16-0.79, p 5 0.01). The estimated c-index was 0.74 using the original Kattan nomogram and 0.78 when the L/M ratio was added. Our study reports for the first time that the pre-operative L/M ratio represents a novel independent prognostic factor for prediction the clinical outcome in STS patients. This easily determinable biomarker might be helpful in improved individual risk assessment.Soft tissue sarcomas (STS) account for nearly 11,280 cases per year and are responsible for about 3,900 deaths in the United States annually, mainly due to local recurrence or metastatic disease. 1 Therefore, it is crucial to understand the biological mechanisms that contribute to tumor progression and to identify novel prognostic markers to generate individualized treatment and follow-up schedules. In a large retrospective study of 2,136 STS patients, Kattan et al. developed a postoperative prognostic model that predicts sarcomaspecific death, based on traditional prognostic factors such as age at diagnosis, tumor size, histologic grade, histologic subtype, tumor depth and site. 2 This nomogram is useful for general risk assessment and has potential value in determining surgical strategy and adjuvant management. Nevertheless, novel prognostic factors might be helpful in improving its predictive ability. Current approaches in cancer research have focused on the characterization of novel biomarkers, which ideally should be easily accessible, highly reproducible, cheap and most importantly, identify patients at high risk for disease-recurrence and death. Increasing evidence su...

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Section: Discussionmentioning

confidence: 87%

The lymphocyte/monocyte ratio predicts poor clinical outcome and improves the predictive accuracy in patients with soft tissue sarcomas

et al. 2014

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“…The presence of an elevated preoperative NLR has been validated as a marker of inflammation, and shown to have prognostic significance for a number of tumors (Jung et al, 2011;Idowu et al, 2012;Liu et al, 2013;Unal et al, 2013), including HNSCC (Trellakis et al, 2011;Millrud et al, 2012;Perisanidis et al, 2013;Rassouli et al, 2013;Tsai et al, 2013). It is considered as a marker of systemic inflammation which may predict worse prognosis by driving cancer cell proliferation through increasing the availability of growth factors, angiogenic factors and other pro-neoplastic signaling molecules (Hanahan and Weinberg, 2011).…”

Section: Discussionmentioning

confidence: 99%

Elevated Neutrophil-to-Lymphocyte Ratio in Squamous Cell Carcinoma of Larynx Compared to Benign and Precancerous Laryngeal Lesions

Kum¹,

Özcan²,

Baklacı³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: Laryngeal carcinogenesis is a multifactorial process that has not been fully elucidated. Despite extensive research, reliable markers with diagnostic and prognostic value are still lacking. It was recently reported that an elevated preoperative neutrophil-to-lymphocyte ratio (NLR) may correlate with an increased risk of recurrence, tumor aggressiveness and poorer prognosis in various malignancies. The aim of this study was to examine whether NLR could be used as an inflammatory marker to differentiate laryngeal squamous cell carcinoma (LSCC) patients from benign laryngeal lesion (BLL) and precancerous laryngeal lesion (PLL) patients. Materials and Methods: This retrospective study was performed on 209 patients admitted to a tertiary referral center with laryngeal lesions and undergoing biopsies to establish their histopathological diagnosis. We reviewed the patient files for their clinical, histopathological and laboratory data. The patients were divided into three groups according to their histopathological findings, as BLL, PLL and LSCC groups. The patients in the PLL group were also divided into three subgroups as mild, moderate and severe dysplasia/ carcinoma in situ (CIS) subgroups. The groups were compared for NLR and the other laboratory data. Results: The mean NLRs of the BLL, PLL and the LSCC groups were 2.12±0.86, 2.32±0.68 and 3.46±1.51, respectively, and the difference was statistically significant (p=0.001). The mean NLRs of the patients with PLL and LSCC were significantly higher than the patients with BLL (p=0.031 and p=0.001, respectively). The mean NLRs were similar among mild dysplasia, moderate dysplasia and severe dysplasia / CIS groups (p>0.05). Conclusions: To our knowledge, this is the first study investigating NLR in BLL, PLL and LSCC. NLR is an inexpensive, reproducible and widely available blood test, and could be a useful inflammatory marker to differentiate LSCC from BLL and PLL.

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“…NLR has been shown to have prognostic value in patients with several types of cancer [22], such as esophageal cancer [10], gastric cancer [9], colorectal cancer [23], pancreatic adenocarcinoma [7], soft tissue sarcoma [24], intrahepatic cholangiocarcinoma [25], and colorectal liver metastasis [26]. The NLR value can be easily calculated using routine laboratory data without any additional cost [6].…”

Section: Discussionmentioning

confidence: 99%

Preoperative Neutrophil-to-Lymphocyte Ratio for Prognostication of Patients with Distal Bile Duct Carcinomas Undergoing Surgery

Iso

Matsumoto²,

Sakuraoka³

et al. 2015

Dig Surg

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Clinical implication of pretreatment neutrophil to lymphocyte ratio in soft tissue sarcoma

Abstract: The preoperative NLR is a simple, investigation predicting the preoperative diagnosis of a soft tissue sarcoma and a predictor of worse overall survival for patient with a soft tissue sarcoma.

Cited by 62 publications

References 40 publications

The lymphocyte/monocyte ratio predicts poor clinical outcome and improves the predictive accuracy in patients with soft tissue sarcomas

The lymphocyte/monocyte ratio predicts poor clinical outcome and improves the predictive accuracy in patients with soft tissue sarcomas

Elevated Neutrophil-to-Lymphocyte Ratio in Squamous Cell Carcinoma of Larynx Compared to Benign and Precancerous Laryngeal Lesions

Preoperative Neutrophil-to-Lymphocyte Ratio for Prognostication of Patients with Distal Bile Duct Carcinomas Undergoing Surgery

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