Platelet-Lymphocyte and Neutrophil-Lymphocyte Ratios Are Prognostic Markers for Pheochromocytomas and Paragangliomas

Abstract

Context Preoperative inflammatory markers, such as the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and lymphocyte-monocyte ratio (LMR), have recently been proposed as prognostic markers in different tumors. However, their predictive values in patients with pheochromocytomas and paragangliomas (PPGLs) are uncertain. The present study aimed to investigate the prognostic significance of these biomarkers in PPGL patients. Objective We assessed whether inflammatory biomarkers are associated with poor prognosis for PPGLs. Design Data from 1247 consecutive PPGL patients between 2002 and 2020 were evaluated. The preoperative inflammatory markers were evaluated. The prognostic roles were identified by X-tile software, Kaplan–Meier curves, and Cox regression models. Results A total of 728 patients were included in the analysis, with a median follow-up of 63 months (IQR, 31–111 months), 31 individuals died, 28 patients developed metastases and 12 patients developed recurrence. Our study showed that death were observed significantly more frequently in patients with high NLR(≥3.5) and high PLR (≥217.4) group than with low NLR(<3.5) (P=0.003) and low PLR(<217.4) group (P=0.005). Elevated NLR (≥3.5) and elevated PLR (≥217.4) was significantly associated with decreased overall survival (OS) (P=0.005), elevated PLR (≥238.3) was significantly associated with decreased Metastasis-free survival (MFS) (P=0.021). Cox models illustrated that NLR and PLR were independent prognostic factors for OS, and PLR was an independent prognostic factor for MFS. Conclusions Both elevated NLR and PLR are associated with poor prognosis in PPGLs. They are convenient predictive markers that could be used in daily clinical practice.

Cardiovascular Complications in Pheochromocytoma and Paraganglioma: Does Phenotype Matter?

“…The responsible mechanisms in PPGL are modulation of thrombopoiesis and platelet function, leading to moderately elevated platelet counts with increased ADP-mediated aggregation. 41 Contributing factors to thrombus formation are erythropoietin and serotonin. 42…”

Efficacies of anlotinib monotherapy versus gemcitabine-based chemotherapy for patients with advanced soft tissue sarcoma after the failure of anthracycline-based chemotherapy

“…Anlotinib is a small-molecule tyrosine kinase inhibitor known for its ability to target various pathways related to tumor angiogenesis and suppress tumor growth (Zhong et al 2023 ). It was approved as a second-line therapy for advanced STS patients who had failed anthracycline treatment, or as a first-line therapy for alveolar soft part sarcoma and clear cell sarcoma in China (Raungkaewmanee et al 2012 ).…”