Preoperative platelet-lymphocyte ratio is superior to neutrophil-lymphocyte ratio as a prognostic factor for soft-tissue sarcoma

Abstract

BackgroundInflammation can promote tumor growth, invasion, angiogenesis and even metastasis. Inflammatory markers have been identified as prognostic indicators in various malignances. This study compared the usefulness of platelet-lymphocyte ratio (PLR) with that of neutrophil-lymphocyte ratio (NLR) for predicting outcomes of patients who underwent radical resection for soft tissue sarcoma (STS).MethodsWe included 222 STS patients in this retrospective study. Kaplan-Meier curves and multivariate Cox proportional models were used to calculate overall survival (OS) and disease free survival (DFS).ResultsIn univariate analysis, elevated PLR and NLR were both significantly associated with decreased OS. In multivariate analysis, PLR (HR: 2.60; 95 % CI: 1.17–5.74, P = 0.019) but not NLR was still identified as independent predictors of outcome. Median OS was 62 and 76 months for the high PLR and low PLR groups, respectively. High PLR and NLR were both significantly associated with shorter DFS in univariate analysis, with median DFS of 18 and 57 months in the high PLR and low PLR groups. In multivariate analysis, elevated PLR (HR: 1.77; 95 % CI: 1.05–2.97, P = 0.032) was also related to decreased DFS.DiscussionOur findings provide a new and valuable clue for diagnosing and monitoring STS. Prediction of disease progression is not only determined by the use of clinical or histopathological factors including tumor grade, tumor size, and tumor site but also by host-response factors such as performance status, weight loss, and systemic inflammatory response. They also significantly affect clinical outcomes. Thus, PLR can be used to enhance clinical prognostication. Furthermore, the PLR can be assessed from peripheral blood tests that are routinely available without any other complicated expenditure, thus providing lower cost and greater convenience for the prognostication.ConclusionElevated preoperative PLR as an independent prognostic factor is superior to NLR in predicting clinical outcome in patients with STS.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-015-1654-6) contains supplementary material, which is available to authorized users.

Preoperative neutrophil‐to‐lymphocyte ratio predicts malignancy and recurrence‐free survival of solid pseudopapillary tumor of the pancreas

“…The reason may be that SPTP involving this location is more likely to result in sinistral portal hypertension presenting with a decreased platelet count . Several studies have shown that elevated PLR was superior to NLR as a prognostic indicator for many malignancies such as breast cancer, soft‐tissue sarcoma, and colorectal carcinoma . We were unable to demonstrate the value of PLR in predicting clinical outcomes of SPTP, probably due to the small sample size.…”

“…28 Several studies have shown that elevated PLR was superior to NLR as a prognostic indicator for many malignancies such as breast cancer, soft-tissue sarcoma, and colorectal carcinoma. [29][30][31] We were unable to demonstrate the value of PLR in predicting clinical outcomes of SPTP, probably due to the small sample size. Indeed, PLR has not been shown as a predictive marker for IPMN-associated malignancy either.…”

Serum creatinine and albumin predict sarcoma‐specific survival in patients with myofibroblastic and fibroblastic sarcomas

“…While some factors, for instance high tumor grade and inadequate surgical resection are established as prognostic parameters associated with poor outcome in soft tissue sarcomas (STS), the significance of new prognostic factors for survival such as preoperative laboratory parameters has become a recent focus in STS research. Markers of systemic inflammation (elevated CRP, neutrophil/lymphocyte ratio) and pre‐treatment anemia have been shown to predict poor outcome in STS patients . Nevertheless, larger STS cohort studies suggest that differences in biological behavior may exist between sarcoma histotypes .…”

“…Markers of systemic inflammation (elevated CRP, neutrophil/lymphocyte ratio) and pretreatment anemia have been shown to predict poor outcome in STS patients. [13][14][15][16] Nevertheless, larger STS cohort studies suggest that differences in biological behavior may exist between sarcoma histotypes. 17 Recently it has been shown, that surgical margins are not predictive of local recurrence and survival in high grade myxofibrosarcoma.…”

Impact of celecoxib on inflammation during cancer surgery: a randomized clinical trial

“…Several studies have reported that altered perioperative immune function (lymphopenia, elevated platelet/lymphocyte ratio) is associated with poor cancer survival. 25,36 Our study found that celecoxib prevented thrombocytosis (an acutephase response), lymphopenia, and hence an elevation of the platelet/lymphocyte ratio during the early perioperative period. Of interest for future study is whether celecoxib preserves lymphocyte subpopulations (e.g.…”