Prognostic value of neutrophil-lymphocyte ratio during palliative chemotherapy in patients with unresectable gallbladder adenocarcinoma.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 253-253
Author(s):  
Jae Woo Lee ◽  
Sang Hyub Lee ◽  
Jun Hyuk Son ◽  
Jinwoo Kang ◽  
Woo Hyun Paik ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Marker ◽  
Palliative Chemotherapy ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Gallbladder Adenocarcinoma ◽  
Auc Value ◽  
Over Time

253 Background: Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) is a valuable prognostic marker in several kinds of solid tumors. This study aimed to evaluate the NLR, PLR and change of NLR and PLR over time as a prognostic marker in unresectable gallbladder cancer (GBC) which is treated with palliative chemotherapy. Methods: A total of 163 patients with pathologically confirmed unresectable GBC were enrolled. Baseline and post 1-cycle chemotherapy NLR and PLR were used in analysis. The changes in NLR and PLR were defined as the ratio of post chemotherapy value to baseline value. The relation between survival time and NLR and PLR changes were analyzed. Results: NLR and PLR had AUC value of 0.679, 0.660 in predicting 1-year overall survival (OS) and NLR 1.96 and PLR 111 were the optimal cutoff value with the highest sum of sensitivity and specificity. NLR change and PLR change had AUC value of 0.517, 0.519 in predicting 1-year OS and NLR change 0.4, PLR change 0.6 were the optimal cutoff value. Patients with NLR lower than 1.96 had better OS (16.1 months vs. 9.5 months, p < 0.001) and similarly patients with PLR lower than 111 had better OS (17.3 months vs. 9.5 months, p < 0.001). However, NLR change lower than 0.4 didn’t show better OS (9.2 months vs. 11.6 months, p = 0.178), and the same with PLR change lower than 0.6 (8.5 months vs. 11.3 months, p = 0.138). Conclusions: Baseline NLR and PLR is a valuable predictor of overall survival in unresectable GBC undergoing palliative chemotherapy, whereas NLR and PLR change over time is not.

scholarly journals THE ROLE OF IMMUNOINFLAMMATORY MARKERS IN THE PROGNOSIS AND RESECTABILITY OF PANCREATIC ADENOCARCINOMA

2018 ◽  
Vol 31 (2) ◽  
Author(s):  
Tatiana Falcão EYFF ◽  
Henrique Rasia BOSI ◽  
Mariana Sandrin TONI ◽  
Mariana Blanck ZILIO ◽  
Carlos Otavio CORSO ◽  
...  
Keyword(s):  
Overall Survival ◽  
Pancreatic Adenocarcinoma ◽  
Palliative Chemotherapy ◽  
Prognostic Impact ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Platelet Lymphocyte Ratio ◽  
Cutoff Values ◽  
The Ideal

ABSTRACT Background: Pancreatic adenocarcinoma has a high mortality rate. A prognostic tool is essential for a better risk stratification. The neutrophil/lymphocyte ratio and adaptations and the platelet/lymphocyte ratio seem promising for this purpose. Aim: Evaluate the prognostic value of neutrophil/lymphocyte ratio, derived neutrophil/lymphocyte ratio and platelet/lymphocyte ratio, analyze the ideal cutoff values and investigate their utility in predicting resectability. Methods: Data were collected of patients with pancreatic adenocarcinoma in Hospital de Clínicas de Porto Alegre between 2003 and 2013. The studied ratios were determined by blood count collected at hospital admission and after two cycles of palliative chemotherapy. Results: Basal neutrophil/lymphocyte ratio, derived neutrophil/lymphocyte ratio and platelet/lymphocyte ratio did not have prognostic impact in survival (p=0.394, p=0.152, p=0.177 respectively). In subgroup analysis of patients submitted to palliative chemotherapy, neutrophil/lymphocyte ratio, derived neutrophil/lymphocyte ratio and platelet/lymphocyte ratio determined after two cycles of chemotherapy were prognostic for overall survival (p=0.003, p=0.009, p=0.001 respectively). The ideal cutoff values found were 4,11 for neutrophil/lymphocyte ratio (sensitivity 83%, specificity 75%), 2,8 for derived neutrophil/lymphocyte ratio (sensitivity 87%, specificity 62,5%) and 362 for platelet/lymphocyte ratio (sensitivity 91%, specificity 62,5%), Neutrophil/lymphocyte ratio, derived neutrophil/lymphocyte ratio and platelet/lymphocyte ratio were not able to predict resectability (p=0.88; p=0.99; p=0.64 respectively). Conclusions: Neutrophil/lymphocyte ratio, derived neutrophil/lymphocyte ratio and platelet/lymphocyte ratio are useful as prognostic markers of overall survival in patients with pancreatic adenocarcinoma submitted to palliative chemotherapy. Its use as resectability predictor could not be demonstrated.

scholarly journals Baseline neutrophil–lymphocyte ratio holds no prognostic value for esophageal and junctional adenocarcinoma in patients treated with neoadjuvant chemotherapy

2019 ◽  
Vol 33 (6) ◽  
Author(s):  
S J M van Hootegem ◽  
B M Smithers ◽  
D C Gotley ◽  
S Brosda ◽  
I G Thomson ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Roc Curve ◽  
Prognostic Value ◽  
Gastroesophageal Junction ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Cox Regression Analysis ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Gastroesophageal Junction Adenocarcinoma

SUMMARY Background: Several studies have reported that neutrophil–lymphocyte ratio (NLR) can predict survival in esophageal and gastroesophageal junction adenocarcinoma, as it reflects systemic inflammation. Hence, we aimed to determine whether baseline NLR holds prognostic value for esophageal adenocarcinoma patients treated with neoadjuvant chemotherapy (nCT) followed by surgery. Methods: We studied the data of 139 patients that received nCT before undergoing esophagectomy with curative intent, all identified from a prospectively maintained database (1998–2016). Pretreatment hematology reports were used to calculate the baseline NLR. A receiver operating characteristic curve (ROC-curve) was plotted to determine an optimal cutoff value. NLR quartiles were used to display possible differences between groups in relation to overall survival (OS) and disease-free survival (DFS) using the method of Kaplan–Meier. Cox regression analysis was performed to assess the prognostic value of NLR. Results: The median OS and DFS times were 46 months (interquartile range [IQR]: 19–166) and 30 months (IQR: 13–166], respectively, for the entire cohort. The ROC-curve showed that NLR has no discriminating power for survival status (area under the curve = 0.462) and therefore no optimal cutoff value could be determined. There were no statistically significant differences in median OS times for NLR quartiles: 65 (Q1), 32 (Q2), 45 (Q3), and 46 months (Q4) (P = 0.926). Similarly, DFS showed no difference between quartile groups, with median survival times of 27 (Q1), 19 (Q2), 36 (Q3), and 20 months (Q4) (P = 0.973). Age, pN, pM, and resection margin were independent prognostic factors for both OS and DFS. On the contrary, NLR was not associated with OS or DFS in univariable and multivariable analyses. Conclusion: Baseline NLR holds no prognostic value for esophageal and gastroesophageal junction adenocarcinoma patients treated with nCT in this study, in contrast to other recently published papers. This result questions the validity of NLR as a reliable prognostic indicator and its clinical usefulness in these patients.

scholarly journals The role of neutrophil-lymphocyte ratio as a prognostic indicator in patients undergoing nephrectomy for renal cell carcinoma

2018 ◽  
Vol 12 (7) ◽  
pp. E348-8 ◽  
Author(s):  
Nathan Grimes ◽  
Cathal Hannan ◽  
Matthew Tyson ◽  
Ali Thwaini
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Primary Tumour ◽  
Preoperative Staging ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

Introduction: Prognosis in patients with cancer is influenced by underlying tumour biology and also the host inflammatory response to the disease. There is limited evidence to suggest that an elevated neutrophil-lymphocyte ratio (NLR) predicts a poorer prognosis in patients undergoing nephrectomy for renal cell carcinoma (RCC). The aim of this paper is to investigate if patients undergoing nephrectomy for RCC with NLR ≤4 have a better overall and recurrence-free survival than patients with NLR >4.Methods: All patients who underwent nephrectomy at a single centre between January 1, 2011 and December 31, 2014 were identified. Patients were included if postoperative histology demonstrated RCC and if preoperative NLR was available. Patients were excluded if nephrectomy was not curative intent (i.e., cytoreductive nephrectomy), if primary tumour was graded to be T3b‒4 disease, if there was presence of nodal or metastatic disease on preoperative staging, or if adequate followup notes were not available. Primary and secondary outcomes were overall survival and recurrence-free survival, respectively.Results: A total of 154 patients were included in analysis of overall survival; 146 patients were included in analysis of recurrence-free survival. Patients with NLR ≤4 had a much better overall survival than patients with NLR >4 (95% vs. 78%; p=0.0219). Patients with NLR >4 also had higher rates of recurrence (p=0.0218).Conclusions: NLR may be a useful tool in identifying patients who may benefit from more frequent surveillance in the early postoperative period and may allow clinicians to offer surveillance schemes tailored to the individual patient.

Preoperative Neutrophil/Lymphocyte Ratio Predicts Overall Survival and Extravesical Disease in Patients Undergoing Radical Cystectomy

2013 ◽  
Vol 27 (8) ◽  
pp. 1046-1050 ◽  
Author(s):  
L. Spencer Krane ◽  
Kyle A. Richards ◽  
A. Karim Kader ◽  
Ronald Davis ◽  
K.C. Balaji ◽  
...  
Keyword(s):  
Overall Survival ◽  
Radical Cystectomy ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Extravesical Disease

scholarly journals Neutrophil-lymphocyte ratio in metastatic breast cancer is not an independent predictor of survival, but depends on other variables

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Alejandra Ivars Rubio ◽  
Juan Carlos Yufera ◽  
Pilar de la Morena ◽  
Ana Fernández Sánchez ◽  
Esther Navarro Manzano ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Metastatic Breast Cancer ◽  
Performance Status ◽  
Univariate Analysis ◽  
Metastatic Breast ◽  
Prognostic Impact ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

AbstractThe prognostic impact of neutrophil-lymphocyte ratio (NLR) in metastatic breast cancer (MBC) has been previously evaluated in early and metastatic mixed breast cancer cohorts or without considering other relevant prognostic factors. Our aim was to determine whether NLR prognostic and predictive value in MBC was dependent on other clinical variables. We studied a consecutive retrospective cohort of patients with MBC from a single centre, with any type of first line systemic treatment. The association of NLR at diagnosis of metastasis with progression free survival (PFS) and overall survival (OS) was evaluated using Cox univariate and multivariate proportional hazard models. In the full cohort, that included 263 MBC patients, a higher than the median (>2.32) NLR was significantly associated with OS in the univariate analysis (HR 1.36, 95% CI 1.00–1.83), but the association was non-significant (HR 1.12, 95% CI 0.80–1.56) when other clinical covariates (performance status, stage at diagnosis, CNS involvement, visceral disease and visceral crisis) were included in the multivariate analysis. No significant association was observed for PFS. In conclusion, MBC patients with higher baseline NLR had worse overall survival, but the prognostic impact of NLR is likely derived from its association with other relevant clinical prognostic factors.

Neutrophil–lymphocyte ratio as a prognostic factor for survival in patients with advanced renal cell carcinoma (Turkish Oncology Group Study)

2020 ◽  
Vol 26 (7) ◽  
pp. 1583-1589
Author(s):  
Mutlu Hizal ◽  
Mehmet AN Sendur ◽  
Hatime Arzu Yasar ◽  
Kadriye Bir Yucel ◽  
Cagatay Arslan ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Kinase Inhibitors ◽  
Advanced Renal Cell Carcinoma ◽  
Study Group ◽  
Poor Overall Survival ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

Background To describe the prognostic value of neutrophil–lymphocyte ratio and its effect on survival in in patients with advanced renal cell carcinoma. Methods We retrospectively analyzed 331 patients. The cut-off value of neutrophil–lymphocyte ratio was specified as “3” which is mostly close—and also clinically easily applicable—to the median neutrophil–lymphocyte ratio level of our study group. High group is identified as neutrophil–lymphocyte ratio >3 (n = 160) and low group is identified as neutrophil–lymphocyte ratio ≤3 (n = 163). Results A total of 331 (with 211 male and 120 female) patients were enrolled to study. The median age of the patients was 58. The International Metastatic RCC Database Consortium risk score is calculated for the 72.8% (n = 241) of the study group and among these patients, favorable, intermediate, and poor risk rates were 22, 45.2, and 32.8%. The total usage of tyrosine kinase inhibitors reached 78% of the patients. The median overall survival was 32 months versus 11 months in the neutrophil–lymphocyte ratio low and high groups, respectively (HR: 0.49 (95% CI 0.37–0.65), p < 0.001). Conclusion In conclusion, the pre-treatment value of elevated neutrophil–lymphocyte ratio might be a predictor of poor overall survival in advanced renal cell carcinoma patients.

Biomarker to cost-effectively harness the technical prowess of palliative radiation: Neutrophil lymphocyte ratio (NLR) and overall survival following palliative radiotherapy in an unselected real-world population of all tumor sites.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 10111-10111
Author(s):  
Santhanam Sundar ◽  
James Price ◽  
Kirsty Clarke ◽  
Thomas Wolfe ◽  
D Thurairasa ◽  
...  
Keyword(s):  
Overall Survival ◽  
Real World ◽  
Cox Regression ◽  
Palliative Radiotherapy ◽  
Standard Of Care ◽  
University Hospital ◽  
World Population ◽  
Single Fraction ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

10111 Background: Single fraction radiotherapy (RT) is standard of care for palliation of pain from bone metastases (ASTRO IJROBP 2011 79:965). But costly, complex, multi-fraction RT is quite often used for palliation of symptoms from various organs. Health care costs are burgeoning (ASCO JCO 2012 30: 1715). Costs can be constrained by judiciously reducing use of unnecessary multi-fraction RT in pts with limited life expectancy. But radiation oncologists’ ability to predict survival is inaccurate. (Chow IJROBP 2005 61:870). Hence we assessed clinical utility of Neutrophil Lymphocyte ratio (NLR) - a routinely available biomarker. Methods: 233 patients (pts) undergoing palliative RT over a 3 month at Nottingham University Hospital. Predominant Tumour SITES: Lung 28% Breast 13% Prostate 13% Colorectal 9% Gastro-Oesophageal 5% Myeloma 5% Bladder 5%. Predominant HISTOLOGY: Adenocarcinoma 61% Squamous Cell 14%. NLR available for 158 pts. Results: A NLR of 4.5 was highly predictive of 90-day mortality & overall survival in an unselected real world population. (Table). No survival benefit seen for multi-fraction RT over single fraction RT across all tumour sites. On survival analysis by Cox regression, increased NLR was significant with a hazard ratio of 2.2 (95% CI 1.3 to 3.7) whereas total radiation dose, use of multiple fractions , age, serum haemoglobin, serum albumin & histology were not significant. Conclusions: In palliative care of advanced cancer, for pts with high NLR (>4.5), Single fraction RT should be the standard of care for palliation of symptoms. [Table: see text]

Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as prognostic factors for locally advanced pancreatic cancer patients.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 326-326
Author(s):  
Byung Min Lee ◽  
Seung Yeun Chung ◽  
Jee Suk Chang ◽  
Kyong Joo Lee ◽  
Si Young Song ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Cancer Patients ◽  
Locally Advanced ◽  
Advanced Pancreatic Cancer ◽  
Locally Advanced Pancreatic Cancer ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Pre Treatment

326 Background: It is well known that locally advanced pancreatic cancer patients have a poor prognosis. Recently, hematologic markers showing systemic inflammatory status such as neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) have aroused much attention due to its potential to predict patient survival. In this study, we investigated whether pre-treatment NLR and PLR independently and in combination would be significant prognostic factors for survival in locally advanced pancreatic cancer patients. Methods: A total of 497 locally advanced (borderline resectable and unresectable) pancreatic cancer patients who received neoadjuvant or definitive chemoradiotherapy (CCRT) between January 2005 and December 2015 were included in this study. NLR and PLR prior to the start of treatment within 2 weeks were defined as pre-treatment NLR and PLR. We divided the patients with the median values of pre-treatment NLR and PLR; NLR < 2.44 group (n = 248), NLR ≥ 2.44 group (n = 249), PLR < 149 group (n = 248) and PLR ≥ 149 (n = 249) group. Overall survival (OS) and progression-free survival (PFS) were compared between each group for NLR and PLR. Results: Median overall survival was 15.7 months (range, 2.3-128.5 months). For NLR, the OS, PFS rates were significantly lower in the NLR ≥ 2.44 group, with 1-year OS rates of 67.9% and 61.5% (p = 0.003) and 1-year PFS rates of 38.1% and 32.4% (p = 0.003), for NLR < 2.44 and ≥ 2.44 group, respectively. The PLR ≥ 149 group also showed significantly poorer OS and PFS than PLR < 149 group. The 1-year OS rates were 68.1% and 61.3% (p = 0.029) and 1-year PFS rates were 37.9% and 32.5% (p = 0.027), for PLR < 149 and ≥ 149 group, respectively. When multivariate analysis was performed, NLR ≥ 2.44 remained as a significant adverse factor for OS (p = 0.011) and PFS (p = 0.026). PLR > 149 also proved to be a significant factor for poorer OS (p = 0.003) and PFS (p = 0.021). Conclusions: Elevated pre-treatment NLR and PLR independently and in combination significantly predicted poor OS and PFS. Pre-treatment NLR and PLR are useful prognostic factors for OS and PFS in locally advanced pancreatic cancer patients.

Sign in / Sign up

Export Citation Format

Share Document