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

Abstract

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.

Comparison of non-myeloablative lymphodepleting preconditioning regimens in patients undergoing adoptive T cell therapy

“…Previous studies have shown that the combination of cell counts, defined as inflammatory indexes, can serve as predictors of response. [34][35][36][37][38][39] As anticipated, the PLR and NLR were lower in ORs from day 5 onwards.…”

Is the Neutrophil-to-Lymphocyte Ratio a Useful Prognostic Indicator in Melanoma Patients?

“…However, it could be argued that NLR and lymph node positivity are not independent variables. Robinson et al published a multicenter cohort study of 1489 stage I–III locoregional melanoma patients and found that and NLR ≥2.3 was correlated with a 30% increased risk of micrometastasis on SLNB [ 12 ].…”

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

“…Recent evidence has demonstrated that cancer-related inflammation plays a crucial role in the development of metastasis in patients with melanoma ( 6 ). Several inflammation-based parameters in blood have been explored as prognostic biomarkers for melanoma, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index, and C-reactive protein (CRP) ( 7 – 9 ). Many studies have confirmed that the PLR is an independent prognostic factor for gastric cancer ( 10 ), bladder cancer ( 11 ), esophageal cancer ( 12 ), breast cancer ( 13 ), and non-small-cell lung cancer ( 14 ).…”