Prognostic significance of pretreatment neutrophil-to-lymphocyte ratio in melanoma patients: A meta-analysis

Zhan, Hui; Ma, Jianying; Jian, Qi-Chao

doi:10.1016/j.cca.2018.05.055

Cited by 36 publications

(26 citation statements)

References 37 publications

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“…We add data to this important deficit in the literature concerning biomarkers in locoregional melanoma and suggest that future researchers seek to evaluate the utility of the baseline NLR in a prospective cohort of individuals with locoregional melanoma, with regular repeated measurements (including immediately after surgery) to better understand the temporal change of this valuable biomarker in melanoma. The translational value of the NLR in the care of patients with melanoma is potentially important because the association between NLR and survival from metastatic melanoma is unequivocal [52]. The systematic review and meta-regression by Ding et al [53] (using data from 12 studies and 3207 individuals with melanoma) showed that the NLR was strongly predictive of overall survival [HR 2.2 (95% CI 1.6, 3.0)] and disease-free survival [HR 2.2 (95% CI 1.8, 2.7)].…”

Section: Discussionmentioning

confidence: 99%

The neutrophil–lymphocyte ratio and locoregional melanoma: a multicentre cohort study

Robinson

Keeble

et al. 2020

Cancer Immunol Immunother

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Objectives The neutrophil-lymphocyte ratio (NLR) is an inflammatory biomarker which is useful in cancer prognostication. We aimed to investigate the differences in baseline NLR between patients with localised and metastatic cutaneous melanoma and how this biomarker changed over time with the recurrence of disease. Methods This multicentre cohort study describes patients treated for Stage I-III cutaneous melanoma over 10 years. The baseline NLR was measured immediately prior to surgery and again at the time of discharge or disease recurrence. The odds ratios (OR) for sentinel node involvement are estimated using mixed-effects logistic regression. The risk of recurrence is estimated using multivariable Cox regression. Results Overall 1489 individuals were included. The mean baseline NLR was higher in patients with palpable nodal disease compared to those with microscopic nodal or localised disease (2.8 versus 2.4 and 2.3, respectively; p < 0.001). A baseline NLR ≥ 2.3 was associated with 30% higher odds of microscopic metastatic melanoma in the sentinel lymph node [adjusted OR 1.3 (95% CI 1.3, 1.3)]. Following surgery, 253 patients (18.7%) developed recurrent melanoma during surveillance although there was no statistically significant association between the baseline NLR and the risk of recurrence [adjusted HR 0.9 (0.7, 1.1)]. Conclusion The NLR is associated with the volume of melanoma at presentation and may predict occult sentinel lymph metastases. Further prospective work is required to investigate how NLR may be modelled against other clinicopathological variables to predict outcomes and to understand the temporal changes in NLR following surgery for melanoma.

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Section: Discussionmentioning

confidence: 99%

The neutrophil–lymphocyte ratio and locoregional melanoma: a multicentre cohort study

Robinson

Keeble

et al. 2020

Cancer Immunol Immunother

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“…Inflammation responses play an important role in tumor initiation, progression, and metastasis ( 29 ). Many inflammatory indicators—derived from the peripheral blood—and cancer-related inflammatory cells have been investigated as prognostic factors for melanoma, such as the NLR, PLR, CRP, and tumor-infiltrating lymphocytes (TILs) ( 7 , 30 , 31 ). Although the prognostic utility of the PLR has been evaluated in patients with melanoma, the results are still controversial ( 15 – 17 , 19 , 20 , 22 ).…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of the Platelet-to-Lymphocyte Ratio in Patients With Melanoma: A Meta-Analysis

Zhang

Gong

2020

Front. Oncol.

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Background: The prognostic role of the platelet-to-lymphocyte ratio (PLR) is controversial in patients with melanoma. Therefore, we performed a meta-analysis to assess the prognostic value of the PLR in patients with melanoma. Methods: PubMed, Web of Science, Embase, Cochrane library, WanFang, and China National Knowledge Infrastructure were searched for eligible studies. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to evaluate the association between the PLR and overall survival (OS) and progression-free survival (PFS). Results: Nine studies with 2,396 patients were included in this meta-analysis. A high PLR was a predictor of shorter OS (HR = 1.67, 95% CI = 1.18-2.38, p = 0.004), but not PFS (HR = 1.53, 95% CI = 0.96-2.44, p = 0.075) in patients with melanoma. Subgroup analysis revealed that the PLR remained a significant prognostic indicator of both OS and PFS in patients with non-metastatic disease; the PLR cutoff value of <120 had a consistent prognostic value. Conclusions: An increased PLR was associated with poor OS of patients with melanoma. Hence, we suggest that the preoperative PLR could be used to identify high-risk patients and provide information regarding the prognosis of patients with melanoma.

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“… 3 , 4 Inflammation factors, such as CRP, NLR, LDH, and Pc, have been studied in various types of solid tumors and have independent prognostic values across tumor types in patients with advanced cancer. 7 , 13 , 24 , 27 – 31 Furthermore, NLR is an inexpensive, easy accessible biomarker that has the potential to be helpful with clinical decision making and stratify patients in clinical trials. Several studies also showed the potential benefit of inflammatory markers as prognostic factors in lung cancer patients.…”

Section: Discussionmentioning

confidence: 99%

Impact of inflammatory markers on survival in patients with limited disease small-cell lung cancer undergoing chemoradiotherapy

Bernhardt¹,

Aufderstrasse²,

König³

et al. 2018

CMAR

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BackgroundSystemic inflammation appears to play a role in the progression of numerous solid tumors by promoting tumor proliferation. Our current study aimed to evaluate the role of inflammatory markers in limited disease (LD) small-cell lung cancer (SCLC) patients undergoing thoracic chemoradiotherapy (TCR).Patients and methodsWe retrospectively analyzed a total number of 350 SCLC patients diagnosed with LD SCLC who received TCR between 1999 and 2017 and had available blood tests within 2 weeks prior to the start of TCR. Serum C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), lactate dehydrogenase (LDH), hemoglobin (Hb) levels, and platelet count (Pc) were evaluated as potential inflammatory markers. Kaplan–Meier survival analysis was performed for overall survival (OS). For comparison of survival curves, the log-rank (Mantel–Cox) test was used. Univariate and multivariate Cox proportional HRs were used to assess the influence of cofactors on OS.ResultsUnivariate analysis for OS revealed a statistically significant effect for LDH >400 U/L (HR 2.05 U/L; 95% CI 1.29–3.26 U/L; P=0.002), prophylactic cranial irradiation (PCI; HR 0.58; 95% CI 0.40–0.85; P=0.005), CRP >50 mg/L (HR 1.49 mg/L; 95% CI 1.05–2.10 mg/L; P=0.026), and Karnofsky performance scale (KPS) <70% (HR 1.35%; 95% CI 1.02–1.80%; P=0.035). NLR, age (>70 years), Hb levels, and Pc did not influence survival. In multivariate analysis, OS was significantly affected by PCI (HR 0.64; 95% CI 0.43–0.94; P=0.026), LDH >400 U/L (HR 1.91 U/L; 95% CI 1.21–3.05 U/L; P=0.006), and CRP >50 mg/L (HR 1.43 mg/L; 95% CI 1.01–2.04 mg/L; P=0.045). KPS (≤70%) did not influence survival in multivariate analysis.ConclusionElevated CRP and LDH seem to be the independent prognostic factors for OS in LD SCLC patients undergoing TCR. However, elevated NLR was not found to be an independent prognostic factor for OS if taken prior to TCR. LDH and CRP are easily available blood tests and do not require additional resources for routine use and could be useful for clinical decision making.

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Prognostic significance of pretreatment neutrophil-to-lymphocyte ratio in melanoma patients: A meta-analysis

Cited by 36 publications

References 37 publications

The neutrophil–lymphocyte ratio and locoregional melanoma: a multicentre cohort study

The neutrophil–lymphocyte ratio and locoregional melanoma: a multicentre cohort study

Prognostic Value of the Platelet-to-Lymphocyte Ratio in Patients With Melanoma: A Meta-Analysis

Impact of inflammatory markers on survival in patients with limited disease small-cell lung cancer undergoing chemoradiotherapy

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