Neutrophil/lymphocyte ratio has a prognostic value for patients with terminal cancer

Abstract

BackgroundDetermining prognosis in advanced cancer is of key importance. Various prognostic scores have been developed. However, they are often very complex. In this study, we evaluated the feasibility of neutrophil/lymphocyte ratio (NLR) as an index to estimate survival in terminal cancer patients.MethodsNLR was calculated retrospectively based on blood tests performed at 3 months, 2 months, 4 weeks, 3 weeks, 2 weeks, 1 week, and within 3 days before death in 160 cancer patients (82 men, 78 women; age range, 33–99 years; mean age, 69.8 years).ResultsNLR increased significantly with time (P < 0.0001). Mean NLR was significantly higher in patients who died within 4 weeks (29.82) than in those who lived more than 4 weeks (6.15). The NLR cutoff point was set at 9.21 according to receiver operating characteristic curve analysis (area under the curve, 0.82; 95 % confidence interval, 0.79–0.85). We inferred that life expectancy would be <4 weeks when NLR >9.21. The sensitivity, specificity, positive predictive value, and negative predictive value were 65.6, 84.1, 90.6, and 51.1 %, respectively. The positive and negative likelihood ratios were 4.125 and 0.409, respectively.ConclusionsNLR appears to be a useful and simple parameter to predict the clinical outcomes of patients with terminal cancer.

Optimal cut-off for neutrophil-to-lymphocyte ratio: Fact or Fantasy? A prospective cohort study in metastatic cancer patients

“…In addition, in another cohort of 134 patients treated with later lines of chemotherapy, we show that NLR prognostic value was still independently associated with worse survival. These results are in line with the fact that the prognostic value of NLR has been demonstrated in a wide range of disease stages, from localized disease to patients receiving palliative care [ 33 ] or terminally ill [ 34 ].…”

“…Published data suggest high variability in the optimal NLR cut-off value, ranging between 1.9 and 9.21 [ 28 , 34 ]. In order to identify the optimal NLR cut-off value in our study, we performed extensive sensitivity analyses.…”

Predictive value of neutrophil-to-lymphocyte ratio in diabetic wound healing

“…13 NLR has been shown to predict outcome in many diseases. It has been shown to have prognostic value to predict survival in terminal cancer 14 and cardiac mortality in stable coronary artery disease. 15 Lou et al 16 and Shiny et al 17 showed that NLR can be used as an indicator of systemic inflammation in diabetic patients.…”

Pretreatment neutrophil-to-lymphocyte ratio and its dynamic changes are associated with the overall survival in advanced cancer patients undergoing palliative care

“…Up to date, only 4 studies have investigated the association between pre-treatment NLR and survival in cancer patients receiving palliative care and they all showed that the pre-treatment NLR was prognostically important 28 29 30 31 . However, unlike the existing 4 studies, whose study population was terminal cancer patients, we investigated the association in advanced cancer patients (including stage III and stage IV) as palliative care was integrated earlier in the course of advanced cancer in our country.…”