Preoperative Neutrophil‐to‐Lymphocyte Ratio (NLR) is Associated with Reduced Disease‐free Survival Following Curative Resection of Pancreatic Adenocarcinoma

Garcea, Giuseppe; Ladwa, N.; Neal, Christopher P.; Metcalfe, Matthew S.; Dennison, Ashley R.; Berry, David P.

doi:10.1007/s00268-011-0984-z

Cited by 180 publications

(135 citation statements)

References 21 publications

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“…21,22 Moreover, inflammation and carcinogenesis are closely associated with impaired immunity. 23 Thus, the elevated NLR in our patients with malignancy may be related with the inflammatory response to the cancer. Our study investigated the relationship between NLR and parathyroid adenoma size.…”

Section: Discussionmentioning

confidence: 74%

Relationship Between the Neutrophil to Lymphocyte Ratio and Parathyroid Adenoma Size in Patients With Primary Hyperparathyroidism

Zeren

Yaylak

Özbay

et al. 2015

International Surgery

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The aim of our study was to evaluate the relationship between neutrophil to lymphocyte ratio (NLR) and adenoma size in parathyroidectomized patients who underwent a parathyroidectomy. The neutrophil to lymphocyte ratio has recently become popular as a biomarker for malignant diseases or for estimating tumor size preoperatively. This study aimed to estimate the relationship between adenoma size and NLR. Furthermore, we assessed whether a higher level of NLR is correlated with the presence of parathyroid carcinoma. A retrospective chart review was performed for patients with parathyroid adenoma who underwent parathyroidectomy between January 2012 and August 2014. Data related to age, sex, NLR, parathyroid hormone level (PTH), preoperative calcium, phosphorus, adenoma size, and pathology reports were collected. The neutrophil to lymphocyte ratio was significantly correlated with calcium levels, PTH levels, parathyroid adenoma size, and the presence of cancer. However, there was no correlation between NLR and age, sex, and phosphorus levels. This study is the first to document a positive correlation between NLR and parathyroid adenoma size, as well as the presence of cancer, in patients who underwent surgery as a result of primary hyperparathyroidism.

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Section: Discussionmentioning

confidence: 74%

Relationship Between the Neutrophil to Lymphocyte Ratio and Parathyroid Adenoma Size in Patients With Primary Hyperparathyroidism

Zeren

Yaylak

Özbay

et al. 2015

International Surgery

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“…Consistent with previous studies of advanced cancers, elevated NLR was a strong prognostic factor. 4,8,11,13,14,16,19,22,27,34 The role of the host inflammatory response in determining tumor spread is increasingly recognized. The association between elevated NLR and poor prognosis has several possible explanations.…”

Section: Figmentioning

confidence: 99%

“…15,35 A systematic inflammatory response leads to changes in the relative levels of circulating white blood cells, resulting in an increase in neutrophils and a decrease in lymphocytes with the progression of cancer. 25 Recently, an association was reported between a high neutrophil-to-lymphocyte ratio (NLR) and shorter survival time in patients with various cancers, 4,8,11,13,14,16,19,22,27,34 including glioblastoma. 3,12,18 However, the value of preoperative NLR in the assessment of candidates for resection for brain metastasis has not been evaluated.…”

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confidence: 99%

Elevated preoperative neutrophil-to-lymphocyte ratio as a predictor of worse survival after resection in patients with brain metastasis

Mitsuya¹,

Nakasu²,

Kurakane

et al. 2017

Journal of Neurosurgery

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B rain metastases occur in 10% to 40% of patients with cancer and are the most common central nervous system neoplasm in adults. 28,33 With increased surveillance, improved control of systemic cancer, and prolonged survival, the incidence of patients with brain metastases is increasing. 17 The management of brain metastases has been revolutionized in clinical oncology by 4 developments: improved brain imaging, improved management of systemic diseases, the distribution of stereotactic irradiation, and the extension of less invasive surgical techniques that enable brain metastases to be removed even from eloquent brain areas with minimal morbidity. 5Although stereotactic irradiation and pharmacotherapies contribute to the treatment outcome of patients with brain metastasis, resection is still a mainstay for large brain metastases.The indications for resection include a symptomatic mass, a mass with considerable edema requiring high-dose ABBREVIATIONS DS-GPA = diagnosis-specific graded prognostic assessment; KPS = Karnofsky Performance Status; NLR = neutrophil-to-lymphocyte ratio; OS = overall survival; RPA = recursive partitioning analysis. SUBMITTED OBJECTIVEThe median postoperative survival duration of patients with brain metastases who undergo tumor resection is 12 months. Most of these patients die of systemic metastases or the progression of primary cancer but not brain metastases. The criteria for indicating resection are still controversial. Systemic assessment is restricted, especially in patients who need emergent management for their large-size or life-threatening brain metastases. The neutrophil-tolymphocyte ratio (NLR) is reported to correlate with survival time or progression-free survival in patients with various cancers. However, NLR has not been assessed in patients with brain metastases. The impact of NLR on the survival data of patients who had undergone resection of brain metastases was retrospectively analyzed. METHODS The clinical records of patients who underwent resection of brain metastases at Shizuoka Cancer Center between May 2007 and January 2015 were retrospectively analyzed. NLR was calculated by using the data obtained from the latest examination before resection and before the administration of steroid therapy. Kaplan-Meier curves were used for the assessment of overall survival (OS). RESULTS Of the 105 patients included, 67 patients were male. The median age of the patients was 63 years (range 36-90 years). The primary cancers were lung, colon, breast, uterus, and other cancers in 48, 19, 10, 8, and 20 patients, respectively. The postresection median survival duration was 12 months (range 1-91 months) for the entire series. The optimum NLR threshold value was identified as 5. A significant difference in the median OS was found: 14 months for 82 patients with an NLR < 5 versus 5 months for 23 patients with an NLR ≥ 5 (p = 0.001). CONCLUSIONS In this study, an elevated preoperative NLR is a predictor of worse survival after resection for brain metastases. NLR is a simple, systemic m...

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“…A number of prognostic factors based on cancer-associated systemic inflammation have been investigated, including the following: Serum C-reactive protein (CRP) combined with albumin levels (modified Glasgow prognostic score; mGPS) ( count (Onodera's prognostic nutritional index; PNI) (22); the neutrophil to lymphocyte ratio (NLR) (23), combining neutrophil and lymphocyte counts; and the platelet to lymphocyte ratio (PLR) (24), combining platelet and lymphocyte counts. However it is unknown whether such prognostic markers correlate with the outcome of preoperative therapy in pancreatic cancer patients.…”

Section: Introductionmentioning

confidence: 99%

Pre-treatment neutrophil to lymphocyte ratio as a predictive marker for pathological response to preoperative chemoradiotherapy in pancreatic cancer

et al. 2015

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Preoperative Neutrophil‐to‐Lymphocyte Ratio (NLR) is Associated with Reduced Disease‐free Survival Following Curative Resection of Pancreatic Adenocarcinoma

Abstract: Preoperative NLR offers important prognostic information regarding disease-free survival following curative resection of pancreatic ductal adenocarcinoma.

Cited by 180 publications

References 21 publications

Relationship Between the Neutrophil to Lymphocyte Ratio and Parathyroid Adenoma Size in Patients With Primary Hyperparathyroidism

Relationship Between the Neutrophil to Lymphocyte Ratio and Parathyroid Adenoma Size in Patients With Primary Hyperparathyroidism

Elevated preoperative neutrophil-to-lymphocyte ratio as a predictor of worse survival after resection in patients with brain metastasis

Pre-treatment neutrophil to lymphocyte ratio as a predictive marker for pathological response to preoperative chemoradiotherapy in pancreatic cancer

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