Prognostic value of neutrophil-to-lymphocyte ratio in patients with glioblastoma

Alexiou, George Α.; Vartholomatos, Evrysthenis; Voulgaris, Spyridon

doi:10.1007/s11060-013-1240-1

Cited by 16 publications

(14 citation statements)

References 2 publications

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“…The rest 10 studies were assessed in full text. One paper was a letter [ 20 ] and was excluded. Two studies [ 17 , 21 ] were performed in the same institution by the same research team, and the study with larger sample and adjusted HR was included [ 17 ].…”

Section: Resultsmentioning

confidence: 99%

Prognostic role of neutrophil lymphocyte ratio in patients with glioma

Zhang

Song

et al. 2017

Oncotarget

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The purpose of this study was to evaluate the prognostic role of neutrophil lymphocyte ratio (NLR) in patients with glioma. PubMed, EMBASE, Cochrane Library and China National Knowledge Infrastructure were searched for relevant literature. The study and patient characteristics were extracted. Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled to estimate the prognostic role of NLR in patients with glioma. Subgroup analysis and sensitivity analysis were also performed. Six studies with 1,021 patients were included. The pooled HR of elevated NLR for OS in patients with glioma was 1.48 (95% CI, 1.25-1.76). Among the included studies, five studies used 4 as the cut-off value of NLR. The pooled HR for OS of the five studies was 1.67 (95% CI, 1.37-2.03). No significant heterogeneity was observed (I2 = 42.4%, P=0. 122). Publication bias was not present. Elevated NLR was associated with poorer overall survival in patients with glioma.

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Section: Resultsmentioning

confidence: 99%

Prognostic role of neutrophil lymphocyte ratio in patients with glioma

Zhang

Song

et al. 2017

Oncotarget

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“…A high NLR and PLR and low LMR are closely associated with a poor prognosis in solid malignancies, including gastrointestinal tumors, prostate cancer, and lung cancer [ 14 – 19 ]. While a low preoperative NLR closely correlates with lower glioma grade and better clinical outcome [ 20 – 22 ], there are no published data assessing the role of PLR or LMR in gliomas. Additionally, the role of the NLR in gliomas requires further study, due to the limited number of cases in previous studies [ 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

“…While a low preoperative NLR closely correlates with lower glioma grade and better clinical outcome [ 20 – 22 ], there are no published data assessing the role of PLR or LMR in gliomas. Additionally, the role of the NLR in gliomas requires further study, due to the limited number of cases in previous studies [ 21 , 22 ]. We therefore hypothesized that the inflammation status would likely vary according to the IDH mutation status, and could serve as a prognostic indicator.…”

Section: Introductionmentioning

confidence: 99%

Preoperative inflammation markers and IDH mutation status predict glioblastoma patient survival

et al. 2017

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Recent studies suggest that inflammation response biomarkers are prognostic indicators of solid tumor outcomes. Here, we quantify the prognostic value of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) in glioblastomas (GBMs), taking into consideration the role of the isocitrate dehydrogenase (IDH) mutation status. We examined 141 primary glioblastomas (pGBMs) and 25 secondary glioblastomas (sGBMs). NLRs, PLRs, and LMRs were calculated before surgery. IDH mutations were detected immunohistochemically after tumor resection, and patients' clinical outcomes were analyzed after classification into GBM, pGBM, and IDH-wild type glioblastoma (IDH-wt GBM) groups. To make comparisons, we set cutoffs for NLR, PLR and LMR of 4.0, 175.0, and 3.7, respectively. In a multivariate analysis, both NLR (HR=1.712, 95% CI 1.026-2.858, p=0.040) and PLR (HR=2.051, 95% CI 1.288-3.267, p=0.002) had independent prognostic value. While a low NLR was associated with a better prognosis only in the IDH-wt GBM group, PLR was predictive of patient survival in the GBM, pGBM, and IDH-wt GBM groups. By contrast, LMR exhibited no prognostic value for any of the 3 types of GBM.

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“…A pre-treatment neutrophil–lymphocyte ratio (NLR) has been shown to be prognostic in several solid tumours. For newly diagnosed GBM patients treated according to the Stupp protocol, no less than four studies have reported that a high ratio (4.1–7.5, depending on the study) before treatment is correlated with a shorter survival [ 23 – 26 ]. This ratio is regarded as a marker of systemic cancer-associated inflammation.…”

Section: Discussionmentioning

confidence: 99%

Absolute numbers of regulatory T cells and neutrophils in corticosteroid-free patients are predictive for response to bevacizumab in recurrent glioblastoma patients

Quillien

Carpentier

Gey

et al. 2019

Cancer Immunol Immunother

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Bevacizumab (Bv) remains frequently prescribed in glioblastoma (GBM) patients, especially at recurrence. We conducted a prospective clinical trial with 29 recurrent GBM patients treated with Bv alone with a longitudinal follow-up of different circulating immune cells [complete blood count, myeloid-derived suppressor cells (MDSCs), classical, intermediate, non-classical and Tie2 monocytes, VEGFR1+ and regulatory T cells (Treg)]. We observed a significant increase for leucocytes, neutrophils, eosinophils and classical monocytes and a decrease for the fraction of Treg during the treatment. The best prognostic values for survival under Bv were obtained for basal neutrophils and Treg. Counts below 3.9 G/L for neutrophils and above 0.011 G/L for Treg were associated with an overall survival of 17.5 and 19.9 months, respectively, as compared with 5.4 and 5.6 months, respectively, for counts above and below these cutoffs ( p = 0.004 and p < 0.001). No prognostic impact was observed for neutrophils in a retrospective cohort of 26 patients treated with nitrosoureas alone. In another retrospective validation cohort of 61 GBM patients treated at recurrence with a Bv-containing regimen, an interaction was observed between neutrophils and corticosteroid intake. The predictive value of neutrophils on survival under Bv was lost in patients treated with corticosteroids, when steroid-free patients with a low neutrophil count had a particularly long median survival of 3.4 years. These two simply accessible criteria (basal neutrophils and steroid intake) could be used to reserve this relatively costly treatment for patients likely to be the most responsive to Bv and prevent unnecessary side effects in others. Electronic supplementary material The online version of this article (10.1007/s00262-019-02317-9) contains supplementary material, which is available to authorised users.

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Prognostic value of neutrophil-to-lymphocyte ratio in patients with glioblastoma

Cited by 16 publications

References 2 publications

Prognostic role of neutrophil lymphocyte ratio in patients with glioma

Prognostic role of neutrophil lymphocyte ratio in patients with glioma

Preoperative inflammation markers and IDH mutation status predict glioblastoma patient survival

Absolute numbers of regulatory T cells and neutrophils in corticosteroid-free patients are predictive for response to bevacizumab in recurrent glioblastoma patients

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