Impact of pre-treatment neutrophil-lymphocyte ratio on outcomes in men receiving radical external beam radiotherapy for localised prostate cancer.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 151-151
Author(s):  
Ciara Lyons ◽  
Sagar Kanabar ◽  
Darren M. Mitchell ◽  
Jacqueline A. Harney ◽  
Jonathan McAleese ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
External Beam Radiotherapy ◽  
Progression Free Survival ◽  
Full Blood Count ◽  
Cancer Specific Survival ◽  
Significance Level ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Pre Treatment

151 Background: There is a shortage of novel biomarkers in clinical use for the diagnosis and management of prostate cancer. The neutrophil-lymphocyte ratio (NLR) is a potentially useful biomarker derived from a standard full blood count from peripheral blood sampling, which is readily available and relatively inexpensive. An elevated NLR has been shown to be a poor prognostic biomarker in many advanced solid cancers, including prostate cancer (PC); however, data on NLR in non-metastatic PC have been inconsistent. The objective of this study was to evaluate baseline NLR as an independent predictor of outcome following radical radiotherapy for non-metastatic PC. Methods: Data from 477 consecutive PC patients treated with radical EBRT between 2005 and 2009 in Northern Ireland were reviewed. Outcomes included biochemical progression-free survival (bPFS; Phoenix definiton), prostate cancer-specific survival (PCSS) and overall survival (OS). A two-tailed Mann-Whitney test (significance level 5%) was used to compare NLR in each group. Results: Complete data for 409 patients were available. At a median follow-up of 75 months (range 12 – 138), 74 men (16%) had biochemical failure (BF), 12 men (3%) had died of PC, and 65 men (14%) had died of all causes. Actuarial 5-year bPFS was 91%, PCSS was 97% and OS was 89%. Median NLR was 2.42 in both the BF and non-BF groups (p = 0.78), 2.21 and 2.42 in men who died from PC and those who did not (p = 0.39) and 2.40 and 2.42 in those men who died from all causes and those men who remained alive (p = 0.83). See Table for additional data. Conclusions: In this cohort with medium- to long-term follow-up, NLR was not predictive for bPFS, PCSS or OS. Multivariate analysis of this cohort is planned. Additional prognostic biomarkers are required in PC. [Table: see text]

Impact of pre-treatment neutrophil-lymphocyte ratio on outcomes in men receiving radical external beam radiotherapy for localised prostate cancer.

2016 ◽  
Vol 34 (15_suppl) ◽  
pp. e16604-e16604
Author(s):  
Ciara Lyons ◽  
Sagar Kanabar ◽  
Darren M. Mitchell ◽  
Jacqueline A. Harney ◽  
Jonathan McAleese ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
External Beam Radiotherapy ◽  
External Beam ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Pre Treatment

Advanced Non Small Cell Lung Cancer Patients with Fewer Numbers of Blood Myeloid Dendritic Cells and CD4 Cells Prior to Treatment Have Inferior Progression-Free Survival: Implications for Cancer Immunotherapy

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4837-4837
Author(s):  
Nutan J. DeJoubner ◽  
Qunna Li ◽  
Wayne A.C. Harris ◽  
Zhibo Wang ◽  
Yuan Liu ◽  
...  
Keyword(s):  
Disease Progression ◽  
Progenitor Cells ◽  
Immune Cells ◽  
Advanced Nsclc ◽  
Progression Free Survival ◽  
Study Entry ◽  
Free Survival ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

Abstract Abstract 4837 Background: The tumor microenvironment includes tumor cells, and host-derived endothelial cells, fibroblasts, innate and adaptive immune cells. Tumors may induce neo-vascularization that supports local tumor growth or immune suppression and tolerance that facilitates tumor metastasis. We hypothesized that the patients with higher numbers of circulating CD34+ endothelial progenitor cells (CD34+/CD146+/CD45-, CEC), a cellular bio-marker for vasculogenesis, would have worse post-treatment outcomes and patients with more hematopoietic progenitor cells (CD34+/CD45+/CD45dim/CD133+, HPC) and Immune cells including T-cells would have better outcomes. Methods: We analyzed blood samples from sixty-two patients with advanced NSCLC at 3 time points: before chemotherapy, after cycle one, and at completion of treatment or progression of disease, in an IRB-approved protocol. CEC, HPC, and immune subsets were measured by high throughput multi-parameter flow cytometry, 2.5,000,000 events were acquired using a lyse, no-wash method optimized for rare event detection. Primary outcomes were progression free survival(PFS) and Overall Survival(OS) from the time of study entry. The patient population was stratified into groups based on optimum cut-off point for each cell subset of interest. Statistical analysis was done with log-rank test and Cox regression. Results: Mean age at diagnosis was 64 (37–87 years), 30 events (death) occurred with median follow-up of 9.3 months. Forty-six patients (74%) had disease progression with a median follow-up of 4.7 months. At baseline lower numbers of WBC, Neutrophil lymphocyte ratio(NLR), CEC, HPC were associated with better PFS, while only WBC and Neutrophil lymphocyte ratio (NLR) were associated with a favorable OS. While lower numbers of Immune cells were associated with worse PFS and OS (increased HR death or relapse) in univariate analysis as noted in the Table. Only covariates that were significant and non collinear were entered in the Multivariable model adjusted for age, gender, smoking, race, TNM stage, pathology, and performance status at diagnosis. This showed that baseline numbers of CD4+ T-cell (HR 0.46; 95% CI 0.33–0.98; p= 0.045), Myeloid DC (HR 0.38; 95% CI 0.39–0.81; p=0.012), HPC (continuous variable) (HR 0.78; 95% CI 0.64–0.93; p= 0.008) were significant for disease progression, while NLR was significant for death after study entry (Figure; HR 3; 95% CI 1.45–6.25; p=0 0.003). Conclusions: In patients with advanced NSCLC, lower numbers of HPC and NLR were associated with improved PFS and OS respectively. Lower numbers of immune subsets at diagnosis were associated with inferior outcomes to treatment, supporting the role for immune-mediated disease control. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Integration of circulating tumor cell and neutrophil-lymphocyte ratio to identify high-risk metastatic castration-resistant prostate cancer patients

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Weelic Chong ◽  
Zhenchao Zhang ◽  
Rui Luo ◽  
Jian Gu ◽  
Jianqing Lin ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Progression Free Survival ◽  
Castration Resistant Prostate Cancer ◽  
Cellsearch System ◽  
Cox Models ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Risk Of Death ◽  
Castration Resistant ◽  
Increased Risk

Abstract Background The neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and circulating tumor cells (CTCs) have been associated with survival in castration-resistant prostate cancer (CRPC). However, no study has examined the prognostic value of NLR and PLR in the context of CTCs. Methods Baseline CTCs from mCRPC patients were enumerated using the CellSearch System. Baseline NLR and PLR values were calculated using the data from routine complete blood counts. The associations of CTC, NLR, and PLR values, individually and jointly, with progression-free survival (PFS) and overall survival (OS), were evaluated using Kaplan-Meier analysis, as well as univariate and multivariate Cox models. Results CTCs were detected in 37 (58.7%) of 63 mCRPC patients, and among them, 16 (25.4%) had ≥5 CTCs. The presence of CTCs was significantly associated with a 4.02-fold increased risk for progression and a 3.72-fold increased risk of death during a median follow-up of 17.6 months. OS was shorter among patients with high levels of NLR or PLR than those with low levels (log-rank P = 0.023 and 0.077). Neither NLR nor PLR was individually associated with PFS. Among the 37 patients with detectable CTCs, those with a high NLR had significantly shorter OS (log-rank P = 0.024); however, among the 26 patients without CTCs, the OS difference between high- and low-NLR groups was not statistically significant. Compared to the patients with CTCs and low NLR, those with CTCs and high levels of NLR had a 3.79-fold risk of death (P = 0.036). This association remained significant after adjusting for covariates (P = 0.031). Combination analyses of CTC and PLR did not yield significant results. Conclusion Among patients with detectable CTCs, the use of NLR could further classify patients into different risk groups, suggesting a complementary role for NLR in CTC-based prognostic stratification in mCRPC.

scholarly journals The use of peripheral blood cells as an assessment of inflammation in prostate cancer in patients attending in surgery department at ESUT teaching hospital, Parklane, Enugu, Nigeria

2020 ◽  
Vol 9 (1) ◽  
pp. 1
Author(s):  
Clara N. Soronnadi ◽  
Nancy C. Ibeh ◽  
Francis O. Ugwene ◽  
Grace I. Amilo ◽  
Anthony J. Ede
Keyword(s):  
Prostate Cancer ◽  
Blood Cells ◽  
Blood Count ◽  
Age Groups ◽  
Post Treatment ◽  
Full Blood Count ◽  
Treatment Results ◽  
Lymphocyte Ratio ◽  
Significant Difference ◽  
Pre Treatment

Background: Full blood count (FBC) is a prerequisite investigation requested from all prostate cancer (PCa) patients pre and post treatment, poor parameter influences the outcome of cancers.Methods: Total subjects consisted of 84 male subjects between the ages 41 to >80 years. Longitudinal study was conducted. Controls and test samples were collected at diagnosis and at different stages of the treatment. Demographic information was obtained using a questionnaire. The data was analyzed using IBM statistical package for social sciences (SPSS) PC, version 20.0; SPSS Inc., Chicago, III., USA; the receiver operating characteristic curve (ROC) curve was obtained via neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR) and platelet-to-lymphocyte ratio (PLR) ratios cut-off determinations. Cox proportional-hazards regression analyses the prognostic factors (duration, ratios) and overall survival (diagnosis to death or last follow-up). A paired sample t-test compared test of significance in pre/post treatment results. The analysis of variance (ANOVA) and Tukey HSD post-hoc, test susceptibility within age groups was done.Results: Increased NLR and LMR were significantly associated with increased hazard ratio (HR) and OS at p<0.05 while PLR, no significant difference at P>0.05 in PCa. In complete blood count (CBC) and erythrocytic sedimentation rate (ESR), control and treatment period, all red blood cell (RBC) parameters showed a significant decrease at p<0.05 in treatment results compared to the pre-treatment results while total platelet (TPLT), total white blood cells (TWBC), NC, LC, ESR showed significant increase at p<0.05 in treatment results compared to pre-treatment results. Age group 41-50 years showed more susceptibility than other age groups with significant decrease at p<0.05 in NC, LC and increased MC.Conclusions: This study supports CBC and ESR biomarkers as a prognostic tool in early detection, treatment and monitoring of disease progression in these subjects.

scholarly journals The neutrophil-lymphocyte ratio has a role in predicting the effectiveness of nivolumab in Japanese patients with metastatic renal cell carcinoma: A multi-institutional retrospective study

2019 ◽  
Author(s):  
Naotaka Nishiyama ◽  
Megumi Hirobe ◽  
Takuya Kikushima ◽  
Masahiro Matsuki ◽  
Atsushi Takahashi ◽  
...  
Keyword(s):  
Objective Response ◽  
Progression Free Survival ◽  
Predictive Marker ◽  
Japanese Patients ◽  
Free Survival ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Initiation Of Therapy ◽  
Better Than

Abstract Background: The neutrophil-lymphocyte ratio (NLR) is a well-known prognostic marker in various cancers. However, its role as a predictive marker for the effectiveness of nivolumab in patients with metastatic RCC (mRCC) remains unclear. We evaluated the relationships between the NLR and progression-free survival (PFS) or overall survival (OS) in mRCC patients treated with nivolumab. Methods: The data of 46 mRCC patients who received nivolumab therapy were collected from six institutes and evaluated. The median follow-up period from treatment with nivolumab was 12.5 months (IQR 10.0-16.7). Results: The median duration of nivolumab therapy was 6.5 months (IQR 3.3-13.7). The objective response rate was 22% and the 1- and 2-year PFS rates were 49.4% and 34.8%, respectively. The median NLR values at baseline and 4 weeks were 3.7 (IQR 2.7-5.2) and 3.7 (IQR 2.5-5.9), respectively. In the multivariate analysis, an NLR of ≥ 3 at 4 weeks was an independent predictor of PFS (P = 0.005) and OS (P = 0.031). The 1-year PFS of patients with an NLR of < 3 at 4 weeks was better than that of those with an NLR of ≥ 3 (83% versus 27%, P = 0.001). The 1-year OS of patients with an NLR of < 3 at 4 weeks was also better than that of those with an NLR of ≥ 3 (94% versus 71%, P = 0.002). Conclusions: Although the baseline NLR was not associated with PFS or OS, an NLR of ≥3 at 4 weeks after the initiation of therapy might be a robust predictor of poor PFS and OS in mRCC patients undergoing sequential treatment with nivolumab.

scholarly journals The Prognostic Significance of Neutrophil-to-Lymphocyte Ratio in Head and Neck Cancer Patients Treated with Radiotherapy

2018 ◽  
Vol 7 (12) ◽  
pp. 512 ◽  
Author(s):  
Yeona Cho ◽  
Jun Kim ◽  
Hong Yoon ◽  
Chang Lee ◽  
Ki Keum ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Characteristic Curve ◽  
Prognostic Significance ◽  
Progression Free Survival ◽  
Therapeutic Approaches ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Pre Treatment

Background: To investigate the prognostic value of pre-treatment neutrophil/lymphocyte ratio (NLR) in patients treated with definitive radiotherapy (RT) for head and neck cancer. Methods: We retrospectively analyzed 621 patients who received definitive RT for nasopharyngeal, oropharyngeal, hypopharyngeal, and laryngeal cancer. An NLR cut-off value of 2.7 was identified using a receiver operating characteristic curve analysis, with overall survival (OS) as an endpoint. Results: The 5-year progression-free survival (PFS) and OS for all patients were 62.3% and 72.1%, respectively. The patients with a high NLR (68%) had a significantly lower 5-year PFS and OS than their counterparts with a low NLR (32%) (PFS: 39.2% vs. 75.8%, p < 0.001; OS: 50.9% vs. 83.8%, p < 0.001). In a subgroup analysis according to primary site, a high NLR also correlated with a lower PFS and OS, except in oropharyngeal cancer, where a high NLR only exhibited a trend towards lower survival. In a multivariate analysis, a high NLR remained an independent prognostic factor for PFS and OS. Conclusion: Head and neck cancer tends to be more aggressive in patients with a high NLR, leading to a poorer outcome after RT. The optimal therapeutic approaches for these patients should be reevaluated, given the unfavorable prognosis.

Adjuvant external beam radiotherapy (EBRT) in the treatment of endometrial cancer: Results of the randomised MRC ASTEC and NCIC CTG EN.5 trial

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 5504-5504 ◽  
Author(s):  
J. Orton ◽  
P. Blake
Keyword(s):  
Endometrial Cancer ◽  
External Beam Radiotherapy ◽  
Secondary Outcome ◽  
Depth Of Invasion ◽  
Significance Level ◽  
Pre Treatment ◽  
Grade 3 ◽  
Degree Of Differentiation ◽  
To Receive

5504 Background: Patients with stage I endometrial cancer at high risk of relapse generally receive adjuvant EBRT following surgery, despite lack of evidence that radiotherapy improves overall survival (OS). ASTEC/EN.5 was designed to investigate whether OS is improved by adjuvant EBRT. An important secondary outcome was pelvic recurrence-free survival. Methods: Patients were randomised to receive immediate EBRT (with linear accelerator delivering 40–46Gy in 20–25 fractions to pelvis) or no EBRT until clinically indicated. Vault brachytherapy (4Gy in 2 fractions (HDR) or 15Gy (LDR)) could be used regardless of EBRT allocation. Centers were required to specify in advance whether brachytherapy would be offered to all patients or to none. The study was powered both to 1) detect a 9–10% absolute improvement in 5-year OS with adjuvant EBRT; and 2) reliably exclude an absolute 5% difference in 5-year OS when combined with other major studies (PORTEC and GOG 99). Results: Between Oct 1996 to Apr 2005, 906 patients (452 EBRT, 454 no EBRT) were randomised internationally. Pre-treatment characteristics were well balanced: median age 66 years; 98% of women WHO PS 0–1; 30% with lymph nodes removed at surgery; 84% endometrioid histology; depth of invasion to endometrium only, inner half and outer half of myometrium 3%, 20% and 77%, respectively; degree of differentiation to grade 1, 2, and 3 26%, 42%, and 31%, respectively. 92% patients in EBRT arm received immediate treatment, 90% receiving all protocol specified treatment. 2% patients in no EBRT arm received immediate EBRT. Brachytherapy was given to 52% patients in both arms. Morbidity was higher in EBRT arm, 56% compared with 24% in no EBRT arm reporting complications of treatment. Grade 3 or higher toxicity was rare. With a median follow-up of 46 months at the time of analysis, 117(13%) have died and 136(17%) have recurred or died. 130 deaths are required to detect a 10% difference in 5-year OS with 5% significance level and 90% power and this will be achieved by April 2007. Conclusions: Compliance was high. Serious complications were rare. The ASTEC/EN.5 trial alone and in combination with PORTEC and GOG99 will answer the question of the benefit of post-operative adjuvant EBRT in patients with endometrial cancer. No significant financial relationships to disclose.

scholarly journals Prognostic Significance of Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio in Metastatic Colorectal Cancer

2021 ◽  
Author(s):  
Gülcan Bulut ◽  
Zehra Narlı Özdemir
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Prognostic Significance ◽  
Progression Free Survival ◽  
First Line ◽  
Roc Curve Analysis ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Pre Treatment ◽  
Line Chemotherapy

Abstract There are many studies on biomarkers for prognosis in the treatment of metastatic colorectal cancer. Neutrophil-lymphocyte radio (NLR) and Platelet-lymphocyte radio (PLR) are of interest with studies revealing the relationship between inflammatory biomarkers and cancer. Our study is a retrospective file study and the contribution of NLR and PLR to progression-free survival (PFS) and overall survival(OS) before first line chemotherapy was investigated regardless treatment. The cut off values of NLR and TLR were determined using ROC curve analysis. NLR and PLR was divided into two groups according to the cut-off points. OS and PFS associated with NLR and TLR were performed by Kaplan-Meier method. In our study, we could not demonstrate the prognostic potential of pre-treatment NLR and PLR in patients with mCRC treated with first-line chemotherapy. Our study was showed that the use of these biomarkers in mCRC is limited.

Outcomes in patients with high-risk prostate cancer treated with definitive versus adjuvant radiation therapy.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 133-133
Author(s):  
Vasu Tumati ◽  
Corbin Jacobs ◽  
James Ying ◽  
Claus G Roehrborn ◽  
Yair Lotan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
High Risk ◽  
Multivariable Analysis ◽  
Progression Free Survival ◽  
Adjuvant Radiation ◽  
Cancer Specific Survival ◽  
Free Survival ◽  
Adjuvant Radiation Therapy

133 Background: 20% of men with prostate cancer (PCa) are diagnosed with high-risk disease. The optimal therapy for these patients, prostatectomy followed by adjuvant radiation therapy (ART) or definitive radiation with androgen deprivation (DRT), is still unclear. Previous randomized trials failed to accrue; therefore we sought to answer this using an IRB-approved retrospective cohort study. Methods: High-risk PCa was defined using NCCN criteria. Adjuvant radiation was defined as radiotherapy started within 6 months of prostatectomy. Biochemical progression-free survival (BPFS), castrate resistance-free survival (CRFS), distant metastasis-free survival (DMFS), prostate cancer-specific survival (PCSS), and overall survival (OS) were calculated using Kaplan-Meier estimates. Biochemical failure was defined using the AUA definition in the ART group and by the Phoenix definition in the DRT group. Castrate resistance was defined as ≥2 episodes of rising PSA with testosterone <50 ng/ml or rising PSA despite second line anti-androgen. Statistical analysis was performed using log rank and Cox testing. Results: 60 men with high-risk PCa treated between 1992-2011 were included in the ART group and 154 men were included in the DRT group. 58% of men in the ART group received short course of androgen depravation therapy (ADT). Nearly all men received 2 years of ADT in the DRT group. The median follow up for the ART group was 62 months and 55 months for the DRT group. Men in ART group were younger (p<0.0001) and had a lower pre-treatment PSA (p=0.0338). Log rank testing revealed the ART group had worse BPFS (5 year: 57% vs. 71%; p=0.008), but there was no difference in the other endpoints including CRFS (p=0.9693), DMFS (p=0.7345), PCSS (p=0.5481), or OS (p=0.2557). On multivariable analysis ADT use, ADT length, type of treatment, and stage were not predictive of BRFS whereas Gleason score was (p=.0001). Conclusions: This study suggests that for high-risk PCa patients there is no difference between DRT and ART with regards to BPFS, CRFS, DMFS, PCSS, or OS. Therefore, over a short follow-up period, there does not appear to be a difference between these approaches. Prospective trials are required to validate this finding.

Study of pre-operative neutrophil–lymphocyte ratio in urothelial carcinoma

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Kausalya Kumari Sahu ◽  
Madhurya Ramineni ◽  
Pooja K. Suresh ◽  
Jyoti R. Kini ◽  
Flora D. Lobo
Keyword(s):  
Urothelial Carcinoma ◽  
Univariate Analysis ◽  
Progression Free Survival ◽  
Pathological Stage ◽  
Tumour Stage ◽  
Tumour Grade ◽  
Cancer Specific Survival ◽  
Free Survival ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

Abstract Objectives Neutrophil–lymphocyte ratio (NLR), as an indicator of heightened systemic inflammatory response, predicts increased disease burden and poor oncological outcomes in urothelial carcinoma (UC). The study was undertaken with an aim to evaluate the association of NLR with clinicopathological variables and survival outcomes. Methods A total of 80 patients of UC were enrolled in the current retrospective study. Pre-operative NLR (within one month prior to the procedure), patient age, sex, tumour grade, pathological stage, recurrence free survival (RFS), progression free survival (PFS) and cancer specific survival (CSS) were recorded. We chose a cut-off value of 2.7 for NLR and patients were divide into two groups (NLR <2.7 and ≥2.7). Results NLR ≥2.7 was significantly associated with advanced tumour stage (p=0.001), but not with tumour grade (p=0.116). Progression (p=0.032) and death rates (p=0.026) were high in patients with NLR ≥2.7. Mean RFS (p=0.03), PFS (p=0.04) and CSS (p=0.04) were reduced in patients with NLR ≥2.7. On univariate analysis, NLR ≥2.7 predicted worse RFS (HR=2.928, p=0.007), PFS (HR=3.180, p=0.006) and CSS (HR=3.109, p=0.016). However, it was not an independent predictor of outcomes on multivariate analysis. Conclusions Tumour stage and grade are the only independent predictors of RFS, PFS and CSS. High NLR at a cut-off value of ≥2.7 is associated with advanced pathological stage, but does not have an independent predictive value for RFS, PFS and CSS.

Sign in / Sign up

Export Citation Format

Share Document