The neutrophil/lymphocyte ratio is an independent prognostic indicator in patients with bone metastasis

Abstract

Abstract. Patients with the most common advanced human cancers such as lung, breast, uterus, and cancers of the digestive system almost always develop bone metastases, with painful and untreatable consequences. This study aimed to determine the prognostic implications of the neutrophil/lymphocyte (N/L) ratio in the peripheral blood of patients with malignant bone metastasis. Study participants were identified from a prospective cohort of cancer patients with bone metastasis. Data for the N/L ratios were obtained from clinical and pathological records and were analyzed together with other known prognostic factors in the multivariate and univariate analyses. The results showed the average N/L ratio of all 497 patients to be 4.25±2.44 (range 0.54-45.50 years). Multivariate analysis revealed that tumor type and a high N/L ratio were significantly associated with poor prognosis. For the high N/L ratio group, the estimated hazard ratio of death was 1.348 [95% confidence interval (CI), 1.062-1.712] compared with the low N/L ratio group. The average N/L ratio of the 225 patients in the surgery group was 2.79±2.46 (range 0.77-22.75 years). Multivariate analysis revealed that a preoperatively high N/L ratio (P=0.013; HR=2.945; 95% CI, 1.256-6.906) was significantly associated with poor prognosis after bone metastasis in the surgery group. In conclusion, the N/L ratio was confirmed to be an independent prognostic factor in patients with bone metastasis. Thus, the N/L ratio may serve as a clinically accessible and useful biomarker for patient survival.

Are Neutrophil/Lymphocyte and Platelet/Lymphocyte Rates in Patients with Non-Small Cell Lung Cancer Associated with Treatment Response and Prognosis?

“…Cendes et al have found that higher NLR associated with poor prognosis in patients with stage IV NSCLC (Cedrés et al, 2012). Wang and colleagues have observed that high NLR was an independent prognostic factor in patients with bone metastasis (Wang et al 2011). Also it has been reported that higher preoperative inflammatory markers including NLR and C-reactive protein predict poor survival in resected NSCLC (Tomita et al, 2012).…”

Treatment of Metastatic Colorectal Cancer With or Without Bevacizumab: Can the Neutrophil/Lymphocyte Ratio Predict the Efficiency of Bevacizumab?

“…NLR seems to correlate with the prognosis of cancer patients (Wang et al, 2011;Cedrés et al, 2012;Ishizuka et al, 2012;Proctor et al, 2012). Botta et al firstly demonstrated the resistance to bevacizumab treatment in lung cancer patients with high NLR (Botta et al, 2013).…”

Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) may be superior to C-reactive protein (CRP) for predicting the occurrence of differentiated thyroid cancer

“…Th e NLR has been shown to be a convenient and inexpensive prognostic biomarker in many human cancers (Azab et al 2012;Kishi et al 2009;Wang et al 2011). Platelet to lymphocyte ratio (PLR) is a novel marker.…”