Neutrophil-to-lymphocyte ratio can predict outcome in extensive-stage small cell lung cancer

Abstract

BackgroundThe neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) were analyzed in various carcinomas and their potential prognostic significance was determined. The objective of present study was to determine the correlation between these parameters and the survival of patients with small cell lung cancer (SCLC), since very few studies have been published on this type of carcinoma.Patients and methodsOne hundred and forty patients diagnosed with SCLC at University Hospital Center Zagreb, between 2012 and 2016 were retrospectively analyzed. Extensive-stage disease (ED) was verified in 80 patients and limited-stage disease (LD) in 60 patients. We analyzed the potential prognostic significance of various laboratory parameters, including NLR, PLR, and LMR, measured before the start of treatment.ResultsDisease extension, response to therapy, chest irradiation and prophylactic cranial irradiation (PCI), as well as hemoglobin, monocyte count, C-reactive protein (CRP), and lactate dehydrogenase (LDH) showed a prognostic significance in all patients. When we analyzed the patients separately, depending on the disease extension, we found that only skin metastases as well as LDH and NLR values, regardless of the cut-off value, had a prognostic significance in ED. Meanwhile, the ECOG performance status, chest irradiation, PCI, and hemoglobin and creatinine values had a prognostic significance in LD.ConclusionsNLR calculated before the start of the treatment had a prognostic significance for ED, while PLR and LMR had no prognostic significance in any of the analyzed groups of patients.

Diversity and heterogeneity of immune states in non-small cell lung cancer and small cell lung cancer

“…We confirm previous reports that show SI is a poor prognostic indicator in NSCLC [ 10 , 35 , 36 ]. However, high IL-6 levels are also known to be a poor prognostic indicator in NSCLC, but we did not find a significant direct linear relationship between IL-6 and NLR values in our cohort [ 20 , 21 ].…”

“…None of SI marker were associated with PFS in SCLC patients. While there are some reports that show a relationship between SI markers and PFS or overall survival (OS) in SCLC [ 10 , 12 , 17 ], others fail to establish an association in this type of disease, which may be a result of suboptimal values to define SI [ 15 ].…”

An Elevated Neutrophil-to-Lymphocyte Ratio Predicts Poor Prognosis in Patients with Liver Cancer after Interventional Treatments

“…However, in our patient data, no relationship between either absolute neutrophil or leucocyte count alone was found to be significantly associated with the prognosis. NLR has been reported as a potential prognostic marker, and the elevated ratio is associated with poor prognosis of different cancers such as breast cancer [13], gastric cancer [14,15], advanced melanoma treated with nivolumab [16], pancreatic cancer [17], and in extensive-stage small cell lung cancer [18]. However, due to the heterogenicity of patient populations, the relationship needs to be analyzed for different patient populations to develop a cut-off that is best fit for specific patient groups (or at least large patient groups), because neutrophil and lymphocyte may vary in response to many factors, including treatment protocols, drugs, and methods.…”

“…Neutrophils in human peripheral blood have the functions of phagocytosis, chemotaxis, and bactericide, and lymphocytes are involved in the immune response [10,11]. Studies have shown that the normal NLR values in an adult, nongeriatric, population in good health are between 0.78 and 3.53 [12], neutrophil-to-lymphocyte ratio (NLR) has a potential as prognostic marker, and the elevated NLR is associated with poor prognosis of diseases and cancers such as breast cancer [13], gastric cancer [14,15], advanced melanoma treated with nivolumab [16], pancreatic cancer [17], in extensive-stage small cell lung cancer [18], and others [19,20]. However, it is unknown whether if it has prognostic value for HCC patients after interventional therapies.…”

The combination of fibrinogen concentrations and the platelet-to-lymphocyte ratio predicts survival in patients with advanced lung adenocarcinoma treated with EGFR-TKIs

“… 7 Recently accumulated evidence indicates that inflammation is an important factor affecting patients’ responses to treatment and prognosis. A series of blood-based markers, including the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), have been reported to be effective for predicting patients’ survival in various cancers, 8 – 10 including NSCLC. 11 Blood coagulation disorder is a common complication of malignant tumors, and recent studies demonstrated that coagulation system activation is associated with progression and metastasis in various cancers.…”