Prognostic value of neutrophil-to-lymphocyte ratio in advanced nasopharyngeal carcinoma: a large institution-based cohort study from an endemic area

Abstract

BackgroundFindings remain unclear whether neutrophil-to-lymphocyte ratio (NLR) detrimentally affects advanced nasopharyngeal carcinoma (NPC) prognosis. We aim to evaluate the prognostic value of NLR in patients with NPC based on a large-scale cohort from an endemic area.MethodsWe selected patients retrospectively from a cohort examining long-term cancer outcomes following diagnosis. Neutrophil counts and lymphocyte counts were assessed prior to treatment. Kaplan–Meier method and log-rank test were used to calculate and compare survival outcomes. Additionally, Cox proportional hazards model was utilized to carry out univariate and multivariate analyses.ResultsBetween October 2009 and August 2012, we enrolled 1550 consecutive NPC patients staged II-IVB. The median value of NLR was 2.27 (interquartile range [IQR], 1.71–3.12). Determined by operating characteristic curve using overall survival (OS) as an endpoint, the cutoff value for NLR was 2.50. At 5 years, NLR > 2.50 was associated with inferior OS (90.3% vs 82.5%; P < 0.001), distant metastasis-free survival (DMFS, 89.4% vs 85.0%; P = 0.014), and progression-free survival (PFS, 80.9% vs 76.5%; P = 0.031) than NLR ≤2.50. In multivariate analysis, NLR was found to be a significant prognostic factor for OS (HR, 1.72; 95% CI, 131–2.24; P < 0.001), DMFS (HR, 1.45; 95% CI, 1.10–1.92; P = 0.009), and PFS (HR, 1.29; 95% CI, 1.04–1.59; P = 0.021).ConclusionPretreatment NLR independently affects survival. Our findings suggest that NLR measurements will be of great clinical significance in the management of NPC.

Low Skeletal Muscle Mass Impairs Quality of Life in Nasopharyngeal Carcinoma Patients Treated With Concurrent Chemoradiotherapy

“…Plasma Epstein-Barr virus DNA levels (copies/mL) were measured using a real-time quantitative polymerase chain reaction assay, and its cutoff value classified as previously described (16,17). Representative hematological biomarkers, such as the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte to lymphocyte ratio (MLR), and prognostic nutritional index (PNI) were assessed, and their cutoffs classified as previously described (18)(19)(20). All patients were observed from fraction 15th to 30th of radiotherapy for 3 weeks.…”

High systemic immune-inflammation index predicts poor prognosis in advanced lung adenocarcinoma patients treated with EGFR-TKIs

“…There have been several immune-inflammation based indicators, including neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) which can predict survival in many solid tumors. [5,6,7,8,9] The systemic immune-inflammation index (SII) is also a simple and inexpensive marker which has been reported to be predictive in the prognosis in colorectal cancer, [10] NSCLC, [11] ovarian cancer, [12] pancreatic cancer, [13] and hepatocellular carcinoma [14] . However, the prognostic value of SII in EGFR-Mutant advanced NSCLC patients treated with EGFR-TKI has been rarely reported.…”

Monocytic Myeloid-Derived Suppressor Cells Underpin Resistance to Adoptive T Cell Therapy in Nasopharyngeal Carcinoma

“…The relationship between lymphocyte and monocyte frequencies was first studied in hematological malignancies but has since been expanded to prognosticate for solid tumors (reviewed in Gu et al 40 and Nishijima et al 41 ), including NPC. [20][21][22][23][24] With the advance of immunotherapy, either as a single treatment or in combinations across many cancer types, the establishment of predictive and prognostic biomarkers has become increasingly complex. Biomarkers for determining ICB have been mixed in their predictive capability.…”