Neutrophil‐to‐lymphocyte ratio is a potential prognostic biomarker for extramammary Paget disease: A retrospective study

Abstract

Extramammary Paget disease (EMPD) is a rare, cutaneous malignancy that may occur in the genital and perianal regions in persons aged >60 years. 1 The incidence rate of EMPD in the United States has increased from approximately 0.3 per 10 million population in 1973 to more than 10 times that rate in 2013. 2 Prognosis of EMPD without distant metastasis is favorable, with a 5-year survival rate of 84%. However, once distant metastases occur, this rate falls to 7%. 3 Several studies have shown that cytotoxic anticancer agents, such as docetaxel, showed some efficacy in advanced EMPD cases.However, curative treatment has not been established, particularly in patients with visceral metastasis. [4][5][6] The neutrophil-to-lymphocyte ratio (NLR) utilizes a ratio of neutrophils to lymphocytes counted in peripheral blood to reflect prognosis and disease activity in many cancer types, including skin cancer. [7][8][9][10] In EMPD, similar to other skin cancers, sentinel lymph node biopsy positivity has been reported to be higher in cases of high NLR values. 8 However, the usefulness of NLR in predicting disease progression or survival in patients with EMPD has not been assessed. We hypothesized that NLR could help predicting prognosis in patients with EMPD and other cancer types. Therefore, we

The Neutrophil-to-Lymphocyte Ratio as a Biomarker in Cutaneous Oncology: A Systematic Review of Evidence beyond Malignant Melanoma

“…Significantly higher NLR values were found in patients with metastatic compared to non-metastatic EMPD at the time of evaluation (mean: 3.39 vs. 2.53; p < 0.005). Moreover, the NLR was an independent prognostic factor for overall survival ( p = 0.019) as well as an independent predictor of survival among EMPD patients with metastatic disease ( p = 0.036) [ 46 ]. In a follow-up multivariate analysis that included 85 patients with EMPD, the same authors found that NLR and a higher invasion level were the two independent predictive factors for SLN biopsy positivity [ 47 ].…”

Untargeted metabolomics yields insight into extramammary Paget’s disease mechanisms

“…The diagnosis of EMPD is frequently delayed, causing older age of patients at diagnosis, which results in decreased survival ( 5 ). Thus, a series of studies focused on the dissection of EMPD pathogenesis of EMPD and biomarkers identification such as neutrophil-to-lymphocyte ratio ( 21 ). Metabolomics is becoming a powerful omics tool, which has been successfully applied to various cutaneous carcinoma including melanoma ( 22 ), cutaneous squamous cell carcinoma ( 23 ), and basal cell carcinoma ( 24 ).…”