The combined use of the neutrophil-lymphocyte ratio and C-reactive protein level as prognostic predictors in adult patients with soft tissue sarcoma

Nakamura, Tomoki; Matsumine, Akihiko; Matsubara, Takehiro; Asanuma, Kunihiro; Uchida, A.; Sudo, Akihiro

doi:10.1002/jso.23424

Cited by 56 publications

(65 citation statements)

References 13 publications

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“…NLR may occasionally not be a tumour-specific marker because other inflammatory conditions and steroid treatments could be confounding factors. Some authors have suggested that NLR should be assessed together with other inflammatory markers such as CRP (Nakamura et al , 2013; Yalcinkaya et al , 2013). In addition, numerous articles have reported on NLR using different cutoff levels that require validation.…”

Section: Discussionmentioning

confidence: 99%

The prognostic impact of the neutrophil-to-lymphocyte ratio in patients with small-cell lung cancer

et al. 2014

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Background:The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are prognostic factors for various types of cancer. In this study, we assessed the association of NLR and PLR with the prognosis of small-cell lung cancer (SCLC) in patients who received the standard treatment.Methods:We retrospectively reviewed patients who were diagnosed with SCLC and treated with platinum-based chemotherapy between July 2006 and October 2013 in Gyeongsang National University Hospital Regional Cancer Center and Changwon Samsung Hospital.Results:In total, 187 patients were evaluated. Compared with low NLR (<4), high NLR (⩾4) at diagnosis was associated with poor performance status, advanced stage, and lower response rate. Median overall survival (OS) and progression-free survival (PFS) were worse in the high-NLR group (high vs low, 11.17 vs 9.20 months, P=0.019 and 6.90 vs 5.49 months, P=0.005, respectively). In contrast, PLR at diagnosis was not associated with OS or PFS (P=0.467 and P=0.205, respectively). In multivariate analysis, stage, lactate dehydrogenase, and NLR at diagnosis were independent prognostic factors for OS and PFS.Conclusions:NLR is easily measurable and reflects the SCLC prognosis. A future prospective study is warranted to confirm our results.

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Section: Discussionmentioning

confidence: 99%

The prognostic impact of the neutrophil-to-lymphocyte ratio in patients with small-cell lung cancer

et al. 2014

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“…Moreover, the combination of 2 biomarkers may increase the predictive ability of individual markers in AMI patients with multiple comorbidities. In previous studies, performed in other disease entities such as cancers, the combined use of NLR and CRP level was found to be helpful for predicting survival 7). It was found that patients with both an elevated CRP level and high NLR had a poorer survival rate than those with either an elevated CRP level or high NLR.…”

Section: Introductionmentioning

confidence: 95%

Combined Use of Neutrophil to Lymphocyte Ratio and C-Reactive Protein Level to Predict Clinical Outcomes in Acute Myocardial Infarction Patients Undergoing Percutaneous Coronary Intervention

et al. 2017

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Background and ObjectivesBoth neutrophil to lymphocyte ratio (NLR) and C-reactive protein (CRP) are biomarkers associated with poor prognosis of patients with acute myocardial infarction (AMI). However, the combined usefulness of NLR and CRP in predicting adverse outcomes has not been investigated.Subjects and MethodsWe analyzed 381 consecutive AMI patients who underwent percutaneous coronary intervention (PCI) from January 2012 to January 2014. The endpoints were all-cause mortality, recurrent myocardial infarction (MI), stent thrombosis, repeat revascularization, stroke, and major adverse cardiac and cerebrovascular events (MACCE) at 2-year follow-up. Included patients were divided into 4 groups according to the optimal cut-off values for NLR and CRP on receiver operating characteristic analysis predicting mortality.ResultsPatients with both high NLR (>6.30) and high CRP (>0.76) had significantly greater risk of all-cause death and MACCE at 24 months, with no significant increase in the risk of recurrent MI, stent thrombosis, or stroke compared with patients with either low NLR or low CRP, as well as those with low NLR and low CRP. Kaplan-Meier analysis revealed significantly lower survival in patients with high NLR-CRP. On Cox multivariate analysis, high NLR-CRP (hazard ratio 23.172, 95% confidence interval 6.575 to 81.671, p<0.001) was an independent predictor of all-cause death.ConclusionElevated levels of both NLR and CRP are associated with increased risk of long-term mortality in AMI patients who have undergone PCI.

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“…Comorbid inflammatory conditions and steroid treatments can confound results. Some authors recommend that these ratios be assessed with other inf lammatory markers such as C-reactive protein, red cell distribution width, and erythrocyte sedimentation rate 25,26 . Validation remains an ongoing consideration because numerous articles have reported on nlr and mlr using different cut-off levels [27][28][29][30] .…”

Section: Figure 2 Kaplan-meier Curves For Overall Survival By Neutropmentioning

confidence: 99%

Prognostic Value of Pretreatment Circulating Neutrophils, Monocytes, and Lymphocytes on Outcomes in Lung Stereotactic Body Radiotherapy

et al. 2016

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PurposeIn the present study, we determined the association of pretreatment circulating neutrophils, monocytes, and lymphocytes with clinical outcomes after lung stereotactic body radiotherapy (sbrt).Methods All patients with primary lung cancer and with a complete blood count within 3 months of lung sbrt from 2005 to 2012 were included. Overall survival (os) was calculated using the Kaplan-Meier method. Factors associated with os were investigated using univariable and multivariable Cox proportional hazards regression. Fine-Gray competing risk regression was performed to test the association of the neutrophil:lymphocyte (nlr) and monocyte:lymphocyte (mlr) ratios with two types of failure: disease-related failure and death, and death unrelated to disease. ResultsOf the 299 sbrt patients identified, 122 were eligible for analysis. The median and range of the nlr and mlr were 3.0 (0.3-22.0) and 0.4 (0.1-1.9) respectively. On multivariable analysis, sex (p = 0.02), T stage (p = 0.04), and nlr (p < 0.01) were associated with os. On multivariable analysis, T stage (p < 0.01) and mlr (p < 0.01) were associated with disease-related failure; mlr (p = 0.03), nlr (p < 0.01), and sbrt dose of 48 Gy in 4 fractions (p = 0.03) and 54 Gy or 60 Gy in 3 fractions (p = 0.02) were associated with disease-unrelated death. Median survival was 4.3 years in the nlr≤3 group (95% confidence interval: 3.5 to not reached) and 2.5 years in the nlr>3 group (95% confidence interval: 1.7 to 4.8; p < 0.01). ConclusionsIn lung sbrt patients, nlr and mlr are independently associated with os and disease-unrelated death.If validated, nlr and mlr could help to identify patients who would benefit most from sbrt.

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The combined use of the neutrophil-lymphocyte ratio and C-reactive protein level as prognostic predictors in adult patients with soft tissue sarcoma

Abstract: We recommend the routine measurement of these markers to identify patients with a greater risk of death.

Cited by 56 publications

References 13 publications

The prognostic impact of the neutrophil-to-lymphocyte ratio in patients with small-cell lung cancer

The prognostic impact of the neutrophil-to-lymphocyte ratio in patients with small-cell lung cancer

Combined Use of Neutrophil to Lymphocyte Ratio and C-Reactive Protein Level to Predict Clinical Outcomes in Acute Myocardial Infarction Patients Undergoing Percutaneous Coronary Intervention

Prognostic Value of Pretreatment Circulating Neutrophils, Monocytes, and Lymphocytes on Outcomes in Lung Stereotactic Body Radiotherapy

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