Prognostic role of pre-treatment neutrophil-to-lymphocyte ratio in patients with soft tissue sarcoma.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e23537-e23537
Author(s):  
Se Jun Park ◽  
Jinsoo Lee ◽  
Kabsoo Shin ◽  
Hyunho Kim ◽  
In-Ho Kim ◽  
...  

e23537 Background: Recent studies suggest that the neutrophil-to-lymphocyte ratio (NLR) may be associated with prognosis in several cancers. However, it has not been widely accepted in a clinical situation. In this study, we investigated the clinical significance of NLR as prognostic marker in patients with soft tissue sarcoma. Methods: Between January 2008 to December 2018, 168 patients with STS who had available blood counts at the time of diagnosis were retrospectively evaluated. Receiver operator characteristic (ROC) curve analysis was used to identify the optimal cut-off value for NLR in predicting overall survival. The association between NLR and overall survival (OS) and disease-free survival (DFS) was analyzed with Kaplan-meier method and multivariate Cox proportional models. Results: A total of 168 patients were analyzed, 116 (69.0%) patients were initially resectable disease. Based on the results of ROC curve analysis, patients were classified into two groups as; high-NLR ( > 1.8) and low-NLR (≤1.8). High-NLR was presented in 107 (63.7%) patients which was significantly associated initial disease status (HR 3.30; 95% CI 1.51-7.20, p= 0.002), but not with age at diagnosis ( p= 0.167). High-NLR was significantly correlated with worse OS (HR 3.14; 95% CI 1.62-6.10, p < 0.001). 3-year DFS was 26.2% for high-NLR group versus 37.3% for low-NLR group. DFS tended to be better in low-NLR group, though not statistically significant (HR 1.65; 95% CI 0.95-2.87, p= 0.078). Conclusions: Pre-treatment NLR is a useful predictive factor for prognosis in patients with soft tissue sarcoma. Further studies are needed to evaluate the association between factors representing of host inflammatory status and cancer prognosis.

2021 ◽  
Vol 41 (1) ◽  
pp. 527-532
Author(s):  
YASUYOSHI SATO ◽  
KENJI NAKANO ◽  
NAOKI FUKUDA ◽  
XIAOFEI WANG ◽  
TETSUYA URASAKI ◽  
...  

2019 ◽  
Vol 34 (2) ◽  
pp. 139-147 ◽  
Author(s):  
Erkan Topkan ◽  
Nur Yücel Ekici ◽  
Yurday Ozdemir ◽  
Ali Ayberk Besen ◽  
Berna Akkus Yildirim ◽  
...  

Background: To retrospectively investigate the influence of pretreatment anemia and hemoglobin levels on the survival of nasopharyngeal carcinoma patients treated with concurrent chemoradiotherapy (C-CRT). Methods: A total of 149 nasopharyngeal carcinoma patients who received C-CRT were included. All patients had received 70 Gy to the primary tumor plus the involved lymph nodes, and 59.4 Gy and 54 Gy to the intermediate- and low-risk neck regions concurrent with 1–3 cycles of cisplatin. Patients were dichotomized into non-anemic and anemic (hemoglobin <12 g/dL (women) or <13 g/dL (men)) groups according to their pre-treatment hemoglobin measures. Receiver operating characteristic (ROC) curve analysis was utilized for accessibility of a pre-treatment hemoglobin cut-off that impacts outcomes. Potential interactions between baseline anemia status and hemoglobin measures and overall survival, locoregional progression-free survival (LRPFS), and progression-free survival were assessed. Results: Anemia was evident in 36 patients (24.1%), which was related to significantly shorter overall survival ( P=0.007), LRPFS ( P<0.021), and progression-free survival ( P=0.003) times; all three endpoints retained significance in multivariate analyses ( P<0.05, for each). A baseline hemoglobin value of 11.0 g/dL exhibited significant association with outcomes in ROC curve analysis: hemoglobin <11.0 g/dL (N=26) was linked with shorter median overall survival ( P<0.001), LRPFS ( P=0.004), and progression-free survival ( P<0.001) times, which also retained significance for all three endpoints in multivariate analyses and suggested a stronger prognostic worth for the hemoglobin <11.0 g/dL cut-off value than the anemia status. Conclusion: Pre-C-CRT hemoglobin <11.0 g/dL has a stronger prognostic worth than the anemia status with regard to LRPFS, progression-free survival, and overall survival for nasopharyngeal carcinoma patients.


Cancers ◽  
2021 ◽  
Vol 13 (24) ◽  
pp. 6266
Author(s):  
Yasuyoshi Sato ◽  
Kenji Nakano ◽  
Xiaofei Wang ◽  
Naoki Fukuda ◽  
Tetsuya Urasaki ◽  
...  

Pazopanib with trabectedin and eribulin is widely used to treat soft-tissue sarcoma (STS). We have shown that baseline neutrophil-to-lymphocyte ratio (NLR) may predict the efficacy and patient prognosis of eribulin. Changes in NLR, but not baseline NLR, can predict patient prognosis of trabectedin. However, prognostic factors of pazopanib for STS have not been identified. We present a retrospective analysis of 141 patients treated with pazopanib for recurrent or metastatic non-round cell STS. Univariate and multivariate analyses were performed to determine the predictive factors of durable clinical benefit (DCB), overall survival (OS), and progression-free survival. L-sarcoma histology (odds ratio [OR] = 0.31, 95% CI = 0.12–0.79; p = 0.014) and pre-treatment NLR < 3.0 (OR = 2.03, 95% CI = 1.02–6.67; p = 0.045) were independent predictive factors of DCB. Pre-treatment NLR < 3.0 (hazard ratio [HR] = 0.55, 95% CI = 0.36–0.84; p = 0.0057), liposarcoma histology (HR = 1.78, 95% CI = 1.09–2.91; p = 0.022), primary extremity site (HR = 0.48, 95% CI = 0.31–0.75; p = 0.0010), ECOG PS ≥ 1 (HR = 1.62, 95% CI = 1.08–2.42; p = 0.019), and CRP < 0.3 (HR = 0.52, 95% CI = 0.33–0.82; p = 0.0050) were independent predictive factors of OS. These findings indicate that baseline NLR predicts the efficacy and patient prognosis of pazopanib for STS.


2017 ◽  
Vol 23 (2) ◽  
pp. 368-374 ◽  
Author(s):  
Hiroshi Kobayashi ◽  
Tomotake Okuma ◽  
Hiroyuki Oka ◽  
Toshihide Hirai ◽  
Takahiro Ohki ◽  
...  

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 11049-11049
Author(s):  
Jason Yongsheng Chan ◽  
Zewen Zhang ◽  
Winston Chew ◽  
Grace Fangmin Tan ◽  
Chloe Liwen Lim ◽  
...  

11049 Background: Recent studies suggest that markers of systemic inflammation such as blood neutrophil-to-lymphocyte ratio (NLR) may be prognostic for various cancers, though its clinical utility has not been widely accepted. This study aims to investigate its clinical relevance in patients (pts) with soft tissue sarcoma (STS). Methods: Five hundred and twenty-nine pts with localized STS who had available pre-operative blood counts at the time of diagnosis were retrospectively examined. An optimal cutoff for high NLR ( > 2.5) in predicting overall survival (OS) and relapse-free survival (RFS) in pts who underwent curative surgery (n = 473) was determined using receiver operating curve analyses. Cutoffs for platelet-lymphocyte ratios (PLR, > 180) and lymphocyte-monocyte ratios (LMR, < 3.6) were similarly obtained. Survival analysis was performed using the Kaplan-Meier method and multivariate Cox proportional models. Median follow-up was 40 months. Results: A high NLR was present in 311 (58.8%) pts, which was significantly associated with tumor grade ( p< 0.0001), depth ( p= 0.003) and size > 5 cm ( p= 0.0242), but not with age at diagnosis, sex or ethnicity. High NLR was associated with both worse OS (HR 1.78; 95%CI 1.28-2.47; p= 0.0005) and RFS (HR 1.54; 95%CI 1.17-2.03; p= 0.0019), as were age at diagnosis, tumor grade, size, PLR and LMR. In multivariate models adjusted for clinicopathological predictors of survival, only NLR, in addition to tumor grade and size, were independently associated with worse OS (HR 1.52; 95%CI 1.09-2.11; p= 0.0131) and RFS (HR 1.42; 95%CI 1.08-1.85; p= 0.0114). Analysis of survival according to American Joint Committee on Cancer (AJCC) stages subdivided as NLR-high and NLR-low revealed a significant worse prognosis for NLR-high subgroups ( p< 0.0001), with a 2.2-fold and 1.5-fold higher risk of death within stages II (HR 2.20; 95%CI 1.20-4.01; p= 0.0103) and III (HR 1.55; 95%CI 1.01-2.37; p= 0.0459), respectively. Conclusions: High NLR is an independent marker of poor prognosis among pts with localized STS. Inclusion of NLR as a classifier into the AJCC staging of STS may improve estimation of survival.


2019 ◽  
Vol 53 (1) ◽  
pp. 39-48 ◽  
Author(s):  
Manca Garbajs ◽  
Primoz Strojan ◽  
Katarina Surlan-Popovic

Abstract Background In the study, the value of pre-treatment dynamic contrast-enhanced (DCE) and diffusion weighted (DW) MRI-derived parameters as well as their changes early during treatment was evaluated for predicting disease-free survival (DFS) and overall survival (OS) in patients with locoregionally advanced head and neck squamous carcinoma (HNSCC) treated with concomitant chemoradiotherapy (cCRT) with cisplatin. Patients and methods MRI scans were performed in 20 patients with locoregionally advanced HNSCC at baseline and after 10 Grays (Gy) of cCRT. Tumour apparent diffusion coefficient (ADC) and DCE parameters (volume transfer constant [Ktrans], extracellular extravascular volume fraction [ve], and plasma volume fraction [Vp]) were measured. Relative changes in parameters from baseline to 10 Gy were calculated. Univariate and multivariate Cox regression analysis were conducted. Receiver operating characteristic (ROC) curve analysis was employed to identify parameters with the best diagnostic performance. Results None of the parameters was identified to predict for DFS. On univariate analysis of OS, lower pre-treatment ADC (p = 0.012), higher pre-treatment Ktrans (p = 0.026), and higher reduction in Ktrans (p = 0.014) from baseline to 10 Gy were identified as significant predictors. Multivariate analysis identified only higher pre-treatment Ktrans (p = 0.026; 95% CI: 0.000–0.132) as an independent predictor of OS. At ROC curve analysis, pre-treatment Ktrans yielded an excellent diagnostic accuracy (area under curve [AUC] = 0.95, sensitivity 93.3%; specificity 80 %). Conclusions In our group of HNSCC patients treated with cisplatin-based cCRT, pre-treatment Ktrans was found to be a good predictor of OS.


Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 3649-3649
Author(s):  
Darko Antic ◽  
Natasa Milic ◽  
Vladimir Otasevic ◽  
Tanja Virijevic Salak ◽  
Vladislava Djurasinovic ◽  
...  

Background: Thromboembolism (TE) is one of major causes of morbidity and mortality in patients with malignancy. Pathophysiological connection between TE and inflammation has been established and it is being thoroughly studied recently. The neutrophil to lymphocyte ratio (NLR) and the platelet to lymphocyte ratio (PLR) are biomarkers for systemic inflammation and might represent a yet unrecognized risk factor for development of venous thromboembolism in lymphoma patients having in mind chronic inflammatory milieu specific for lymphomas. Aims: We aimed to investigate the association between NLR, PLR and future risk of TE, in a prospective cohort of lymphoma patients receiving chemotherapy. Methods: We prospectively included 630 patients with B cell non Hodgkin lymphoma /indolent and agressive/, T cell non Hodgkin lymphoma and Hodgkin lymphoma who were diagnosed and treated (period 2014-2019.) at the Clinic for Hematology, Clinical Center of Serbia. Data for newly diagnosed patients, who had completed a minimum of one chemotherapy cycle, were collected for venous TE events from time of diagnosis to 3 months after the last cycle of therapy. NLR and PLR were calculated according to the CBC with differential count. TE complications were diagnosed based on clinical examination, laboratory evaluation and radiographic studies (duplex venous ultrasound, contrast-enhanced computed tomography scan, magnetic resonance imaging (MRI)). Response to therapy was assessed according to Cheson criteria. Logistic regression analysis and ROC curve were performed to assess the association of NLR and PLR with TE and therapy response. Cox regression and Kaplan Meier analysis were used to assess overall survival. Results: The mean age in our group of patients was 53 years (range, 18-89 years) while 52.8% were males. Most patients had advanced stage disease: clinical stage III 20.6% and stage IV, 41.5%. A total of 327 patients (51.9%) had aggressive NHL; 175 (27.8%) had indolent NHL; 102 (16.2%) had HL; 26 (4.1%) had T cell NHL. 51 (8.2%) patients developed thromboembolic events. NLR and PLR were significantly higher in TE patients compared to patients without TE (p=0.001 and p=0.002, respectively). The NLR was positively associated with PLR (p&lt;0.001). A positive NLR was considered 3 or higher, while a positive PLR was a ratio of 10 or more. The ROC curve analysis demonstrated acceptable specificity and sensitivity of NLR and PLR in predicting TE. NLR and PLR were found to be prognostic factors for the TE (relative risk [RR] = 2.9, 95% confidence interval [CI] = 1.6-5.3, p=0.001 and RR=2.7, 95% CI =1.4-5.1, p=0.002, respectively) as well as for overall response to therapy (RR=2.7, 95%CI=1.7-5.7, p&lt;0.001 and RR=2.0, 95%CI=1.1-3.4, p=0.015, respectively). Regarding the overall survival, in univariate analysis there was an association of the development of TE and decreased survival, while in multivariate model NLR was found to be an independent risk factor for overall survival in lymphoma patients (HR=1.8, 95%CI=1.1-2.9, p=0.024) (Figure 1). Summary/Conclusion: NLR could represent useful clinical predictor of TE complications in patients with lymphoma without additional costs to the national health systems. Our research showed that NLR is also predictive for response to therapy and overall survival of lymphoma patients. Simplicity, cost effectiveness, and rapid turn around qualify this new tool for routine prognostic assessment in lymphoma patients. Figure 1 Disclosures No relevant conflicts of interest to declare.


2021 ◽  
Author(s):  
EFSUN SOMAY ◽  
BUSRA YILMAZ

Abstract Background To retrospectively assess the significance of the pretreatment systemic immune-inflammation index (SII) in predicting the success of temporomandibular joint arthrocentesis (TMJA) at 1-week, 1- month, and 6-month time points. Methods A sum of 136 patients with disc displacement without reduction (DDwo-red) who underwent TMJA was included. For each patient, pre-TMJA SII was calculated as; SII = Platelets × neutrophils/lymphocytes. The success criteria of TMJA included MMO > 35 mm and VAS ≤ 3. The optimal pre-TMJA SII cutoff that predicts TMJA success was determined using receiver operating characteristic (ROC) curve analysis. The primary endpoint was the link between the pre-treatment SII and TMJA success. Results The median pre-TMJA jaw locking duration, maximum mouth opening (MMO), and visual analog score (VAS) were 7 days, 24 mm, and 8, respectively. The overall TMJA success rates were determined as 80.1%, 91.9%, and 69.1% at 1-week, 1-month, and 6-months, respectively. The results of ROC curve analysis exhibited the optimal SII cutoff at 526 (AUC:67.4%; sensitivity:66.7%; specificity:64.2%) that grouped the patients into two subgroups: Group 1: SII ≤ 526(N = 81) and SII > 526(N = 55), respectively. Spearman correlation analysis revealed a strong inverse relationship between the pretreatment SII values and the success of TMJA 1-week (rs: -0.83; P = 0.008) and 1-month, (rs:-0.89; p = 0.03). Comparative analyses displayed that TMJA success rates at 1-week (87.7% versus 69.1%; P = 0.008) and 1-month (96.2% versus 80%; p = 0.03) were significantly higher in the SII ≤ 526 than SII > 526 group, respectively, while the 6-month results favored the SII ≤ 526 group with a trend approaching significance (p = 0.084). Conclusion The current study's findings suggested the SII as a unique independent prognostic biomarker that accurately predicts treatment outcomes for up to 6 months. Trial registration: The results of this research were retrospectively registered.


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