A high neutrophil-to-lymphocyte ratio as a potential marker of mortality in patients with Merkel cell carcinoma: A retrospective study

Zaragoza, J.; Kervarrec, Thibault; Touzé, Antoine; Avenel-Audran, M.; Bénéton, N.; Estève, É.; Hainaut, E.; Aubin, F.; Machet, L.; Samimi, Mahtab

doi:10.1016/j.jaad.2016.05.045

Cited by 22 publications

(18 citation statements)

References 49 publications

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“…The NLR was calculated and was considered high if NLR ≥ 378 or ≥ 4 25. For all statistical analysis of biological data, we first analysed the median value as a cut-off.…”

Section: Methodsmentioning

confidence: 99%

“…OS were assessed using the Kaplan–Meier method and comparisons were performed using the log-rank test. For continuous variables, the chosen cut-off level chosen was their median value and we explored cut-offs described in the literature for Ki-67 (55%)3, CgA (2 ULN)34, NSE (2 ULN)423, LDH (2 ULN)3426, and NLR (≥3 or ≥4)7825. Only variables with a P value of < 0.05 according to univariate analysis were introduced in the Cox model.…”

Section: Methodsmentioning

confidence: 99%

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Prognostic factors in neuroendocrine carcinoma: biological markers are more useful than histomorphological markers

Freis

Graillot

Rousset

et al. 2017

Sci Rep

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Gastroenteropancreatic neuroendocrine carcinomas (GEP-NEC) are a very aggressive type of cancer, for which prognostic factors are lacking. We analysed clinical and histomorphological prognostic markers of overall survival (OS), completed with a record of biological and haematological data of patients diagnosed between December 2002 and December 2015. The median OS was 16 months (95% CI 13.9–18.1). After univariate analysis, performance status (PS) ≥ 2 and stage IV were associated with a worse outcome (9 months and 14 months, respectively), as well as patients with lactate dehydrogenase (LDH) and aspartate aminotransferase (AST) levels ≥ 2 ULN (9 months and 8 months, respectively). After multivariate analysis, LDH and AST levels were the only factors that remained significantly associated with better survival: HR 0.36 (p = 0.04) and 0.31 (p = 0.03), respectively. When patients had elevated LDH and AST levels, OS was 20 months, when they had high LDH or AST levels, 13 months and 8 months in the group with low LDH and AST levels (p < 0.001). Therefore, biological data appeared to be more relevant prognostic factors than usual factors described in other studies (PS, stage, and Ki-67). Considering LDH and AST levels at diagnosis could help physicians to predict survival and to stratify patients for clinical trials.

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“…The NLR was calculated and was considered high if NLR ≥ 378 or ≥ 4 25. For all statistical analysis of biological data, we first analysed the median value as a cut-off.…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Prognostic factors in neuroendocrine carcinoma: biological markers are more useful than histomorphological markers

Freis

Graillot

Rousset

et al. 2017

Sci Rep

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“…LVI and immunosuppression are risk factors of particular concern because they are associated with many-fold increased risk of recurrence or progression, at least in some studies. 50,59,108,110,141,149,182,191 Associations with survival have been reported in some but not all studies evaluating the prognostic value of LVI 29,34,108,128,170,[192][193][194] and immunosuppression. 15,33,38,51,52,59,110,154,[195][196][197] Adjuvant RT to the primary site is generally recommended for all other cases, especially for patients with microscopic or grossly positive margins or other risk factors for recurrence.…”

Section: Nccn Recommendations For Postoperative Management Of the Primentioning

confidence: 99%

Merkel Cell Carcinoma, Version 1.2018, NCCN Clinical Practice Guidelines in Oncology

Bichakjian¹,

Olencki

Aasi

et al. 2018

J Natl Compr Canc Netw

215

279

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This selection from the NCCN Guidelines for Merkel Cell Carcinoma (MCC) focuses on areas impacted by recently emerging data, including sections describing MCC risk factors, diagnosis, workup, follow-up, and management of advanced disease with radiation and systemic therapy. Included in these sections are discussion of the new recommendations for use of Merkel cell polyomavirus as a biomarker and new recommendations for use of checkpoint immunotherapies to treat metastatic or unresectable disease. The next update of the complete version of the NCCN Guidelines for MCC will include more detailed information about elements of pathology and addresses additional aspects of management of MCC, including surgical management of the primary tumor and draining nodal basin, radiation therapy as primary treatment, and management of recurrence.

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“…In this current study, with 89 patients included in the analysis, a high N:CD8 ratio in the tumor was an independent prognostic marker of poor MCC-specific survival in both univariate and multivariate analysis. One recently published study examined its role in the peripheral blood of MCC patients, where a high N:CD8 ratio at baseline associated with a poor MCC-specific survival [45]. This may be due to the role of neutrophils in suppressing the antitumor effect of lymphocytes [30].…”

Section: Discussionmentioning

confidence: 99%

Tumor Ulceration, Reduced Infiltration of CD8-Lymphocytes, High Neutrophil-to-CD8-Lymphocyte Ratio and Absence of MC Virus are Negative Prognostic Markers for Patients with Merkel Cell Carcinoma

Naseri

Steiniche

Georgsen

et al. 2020

Cancers

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(1) Background: Merkel cell carcinoma (MCC) is caused by the Merkel cell polyomavirus and UV radiation. Understanding of the underlying biology is limited, but identification of prognostic markers may lead to better prognostic stratification for the patients. (2) Methods: Ninety patients diagnosed with MCC (1996–2012) were included. Virus status was estimated by polymerase chain reaction (qPCR) and immunohistochemistry (IHC). Ulceration status, PD-L1, cd66b neutrophils, cd8 lymphocytes and biomarkers of vascularization (cd34 endothelial cells) and migration (e-cadherin) were estimated by IHC and analyzed with digital pathology. (3) Results: Virus was present in 47% of patient samples and correlated with lower E-cadherin expression (p = 0.0005), lower neutrophil-to-CD8 lymphocyte ratio (N:CD8 ratio) (p = 0.02) and increased PD-L1 expression (p = 0.03). Ulceration was associated with absence of virus (p = 0.03), increased neutrophil infiltration (p < 0.0001) and reduced CD8 lymphocyte infiltration (p = 0.04). In multivariate analysis, presence of virus (p = 0.01), ulceration (p = 0.05) and increased CD8 lymphocyte infiltration (p = 0.001) showed independent prognostic impacts on MCC-specific survival. (3) Conclusions: In this study, we found that a high N:CD8 ratio, ulceration, virus-negative status and absence of CD8 lymphocytes are negative prognostic markers. Accurate prognostic stratification of the patients may be important in the clinical setting for determination of adjuvant treatment.

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A high neutrophil-to-lymphocyte ratio as a potential marker of mortality in patients with Merkel cell carcinoma: A retrospective study

Cited by 22 publications

References 49 publications

Prognostic factors in neuroendocrine carcinoma: biological markers are more useful than histomorphological markers

Prognostic factors in neuroendocrine carcinoma: biological markers are more useful than histomorphological markers

Merkel Cell Carcinoma, Version 1.2018, NCCN Clinical Practice Guidelines in Oncology

Tumor Ulceration, Reduced Infiltration of CD8-Lymphocytes, High Neutrophil-to-CD8-Lymphocyte Ratio and Absence of MC Virus are Negative Prognostic Markers for Patients with Merkel Cell Carcinoma

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