Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio and one year survival of lung cancer in Sanglah hospital

Abstract

Background: Lung cancer is ranked third as the most common cancer in Indonesia. The one-year survival rate of advanced-stage non-small cell lung carcinoma (NSCLC) patient is quite low, that is 24.6%. Effective and inexpensive prognostic markers need to be further studied due to an increasing incidence of cancer. Inflammation plays an important role in tumorigenesis and research showed an association of NLR and PLR values with poor prognosis in patients with various solid tumors, but current cut off values still vary. This study wanted to determine the value of NLR, PLR and their relationship with the survival rate of advanced stage NSCLC patients at Sanglah hospital.Methods: A retrospective cohort study using the medical record of 96 advanced-stage NSCLC patients who underwent treatment since January 2018 in Sanglah hospital, was closely monitored for a year since diagnosed. Analysis was performed with ROC, Kaplan Meier analysis, log rank test, and time independent cox regression model.Results: The one-year survival rate of advanced stage NSCLC patient is 14.6%, with median survival 3.26 months. Cut off NLR> 3.37, median survival 2.66, p=0.00. Cut off PLR>178.55, median survival 3.26, p=0.35. Multivariate analysis showed that NLR, HR=2.75 and performance status, HR=1.78 were associated with survival.Conclusions: NLR with cut off >3.37 is associated with one-year survival rate of advanced-stage NSCLC patient. PLR did not have any significant association with one-year survival rate of advanced-stage NSCLC patient.

The Relationship Between Neutrophil Lymphocyte Ratio and C-Reactive Protein with Depression and Quality of Life in Non-Small-Cell Lung Cancer Patient

“…Based on the level of education, the study subjects were dominated by a group of patients who never went to school or received primary to secondary education with a case percentage of 86.4%. This finding is in line with the results of a previous study which found that only 9.4% of lung cancer patients received higher education [19] Another study found that 30.8% of lung cancer patients had higher education (Alam, et al, 2020).…”

“…In this study, it was found that most of the subjects were working or had worked as much as 82.7% and the rest had never worked or were housewives. This result resembles the findings of a previous study where only 28% were housewives and the rest worked either as farmers, construction laborers, private workers or government workers [19].…”

“…The neutrophil-lymphocyte ratio is widely studied and associated with the prognosis of lung cancer patients. As a previous study found that a neutrophil lymphocyte ratio >3.37 was associated with 1-year survival of advanced non-small cell lung carcinoma patients [19]. Another study found a high neutrophil lymphocyte ratio as an independent factor for poor prognosis in non-small cell lung carcinoma patients who had not started therapy, with a cutoff value of NLR ≥ 5 [35].…”

“…The physical appearance status in this study found that most had a good appearance with an ECOG score ≤ 2 (94.5%). While previous research found that 68.8% had an ECOG score ≤ 2 (Andikayasa, et al, 2022). ECOG scores are said to correlate with the quality of life of lung cancer patients, where low quality of life with clinically significant symptom incidence is found more in patients with poor physical appearance compared to good ones [28].…”