The neutrophil-to-lymphocyte ratio (NLR) predicts adrenocortical carcinoma and is correlated with the prognosis

Mochizuki, Takashi; Kawahara, Takashi; Takamoto, Daiji; Makiyama, Kazuhide; Hattori, Yusuke; Teranishi, Jun‐ichi; Miyoshi, Yasuhide; Yumura, Yasushi; Yao, Masahiro; Uemura, Hiroji

doi:10.1186/s12894-017-0240-4

Cited by 19 publications

(20 citation statements)

References 17 publications

(24 reference statements)

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“…This observation is based on a very limited number of patients and has, therefore, a weak inferential power. NLR, however, has already shown to be a significant prognostic factor both in ACC ( 23 , 24 ) and in other neoplasms ( 25 , 26 ). Further interest of NLR in ACC derives from the fact that it may be increased from endogenous cortisol and/or from exogenous steroid replacement therapy that is a frequent condition in ACC patients ( 27 ).…”

Section: Discussionmentioning

confidence: 99%

Clinical Prognostic Factors in Patients With Metastatic Adrenocortical Carcinoma Treated With Second Line Gemcitabine Plus Capecitabine Chemotherapy

et al. 2021

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Gemcitabine plus Capecitabine (Gem/Cape) is a frequently adopted second line chemotherapy for metastatic adrenocortical carcinoma (ACC), but only a minority of patients is destined to obtain a clinical benefit. The identification of baseline predictive factors of efficacy is relevant. We retrospectively analyzed clinical data from 50 consecutive patients with metastatic progressing ACC treated between 2011 and 2019. Patients received intravenous Gemcitabine and oral Capecitabine on a metronomic schedule. Previous mitotane therapy was maintained. Clinical benefit (partial response + stable disease) at 4 months was 30%, median progression-free survival (PFS) and disease-specific survival (DSS) from Gem/Cape start were 3 and 8 months, respectively. Among clinical variables evaluated before the start of Gem/Cape, presence of ECOG performance status ≥1 [HR 6.93 95% confidence interval (CI) 0.03–0.54, p.004] and neutrophil-to-lymphocyte ratio (NLR) ≥5 [HR 3.88, 95% (CI) 0.81–0.90, p.003] were independent indicators of poor PFS at multivariate analysis. Conversely, surgery of primary tumor, the presence of lung or lymph-node metastases, blood mitotane level, anemia, and the Advanced Lung cancer Inflammation index (ALI) failed to be independently associated. This study confirms that the Gem/Cape schedule is modestly active in heavily pretreated ACC patients (28% received at least two previous chemotherapy lines). NLR and performance status (PS) are easily available clinical parameters that are helpful to identify patients not likely to derive significant advantage from Gem/Cape chemotherapy.

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Section: Discussionmentioning

confidence: 99%

Clinical Prognostic Factors in Patients With Metastatic Adrenocortical Carcinoma Treated With Second Line Gemcitabine Plus Capecitabine Chemotherapy

et al. 2021

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“…[14][15][16][17][18][19] Th e prognostic signifi cance of NLR in adrenocor-tical cancer (ACC) has been investigated and correlated with poor prognosis. [20][21] However, we did not fi nd an article in the literature where these markers were investigated in the functional distinction of adrenal incidentaloma.…”

Section: Introductionmentioning

confidence: 98%

Adrenal İnsidenteloma Olgularında Hemogram Parametrelerinin Değerlendirilmesi ve Klinik Önemi

Demirci¹,

Varım²,

Cengiz³

et al. 2020

Sakarya Medical Journal

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Objective Adrenal incidentaloma (AI) are randomly detected masses in magnetic resonance imaging (MRI) or computed tomography (CT) scans taken for different reasons. Although AI is not generally known as an inflammatory clinical condition, its proinflammatory properties have been demonstrated. In this study, we aimed to investigate the relationship between AI and neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) and its clinical significance. Materials and Methods A total of 178 patients who were followed up in the Endocrinology clinic due to AI between January 2018 and December 2019 were retrospectively screened and analyzed.

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“…What's more interesting was that the neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) might be new biomarkers for predicting the prognosis of adrenal tumor patients. The higher NLR group (NLR ≥ 5) showed a signi cantly poorer OS [56] , whereas preoperative LMR greater than 4 were associated with longer CSS [57] .…”

Section: Discussionmentioning

confidence: 97%

Summary of clinical characteristics of common primary adrenal malignancies in adults

zhang¹,

wang²,

Li³

et al. 2020

Preprint

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Background To summary the clinical characteristics of common primary adrenal malignancies in adults, the survival time of the patients, and the prognostic factors associated with these rare malignancies. Methods The Surveillance, Epidemiology, and End Results database (1975–2016) was queried for all patients who were diagnosed with primary adrenal malignancies, including adrenocortical carcinoma(ACC), pheochromocytoma and paraganglioma (PPGL), lymphoma, and sarcoma (SA). The clinical characteristics, overall survival (OS) and cancer-specific survival (CSS) were analyzed, in which propensity score methodology, logistic regression modeling and Kaplan-Meier survival curves were used. The Multivariate Cox proportional hazard model was used to identify factors affecting the prognosis of patients with ACC. Results 3204 patients with primary adrenal malignancies were identified, including 2180 with ACC, 593 with PPGL, 307 with lymphoma, and 124 with SA. Generally, PPGL had a better prognosis than others. For ACC and PPGL, the non-metastatic group had better OS and CSS than the metastatic group; for SA, the non-metastatic group had better OS, however, there was no significant difference in CSS between the two groups. Furthermore, For ACC, the single metastasis group had a better OS than the multiple metastasis group. After tumors metastasis, the surgery group, surgery of primary adrenal lesions, had better OS and CSS than the non-surgery group for ACC and PPGL. For lymphoma, the chemotherapy group had better OS and CSS; for ACC and PPGL, the chemotherapy group had better CSS and worse OS; for SA, the survival showed no significant difference between the two groups. Radiotherapy had the same effect on patients' survival as chemotherapy, except for the lymphoma and the ACC. As for lymphoma, the radiotherapy group had better CSS, whereas the survival showed no significant difference in OS between the two groups. For ACC, the non- radiotherapy group had better CSS and OS. More importantly, for lymphoma, under the condition that both cohorts were the same basically, the surgical group had a better prognosis. The prognosis of ACC was related to sex, age, seer historic stage, surgery, chemotherapy. Conclusion Understanding the clinical characteristics of these tumors and factors affecting prognosis can facilitate the selection of more appropriate clinical treatment options.

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The neutrophil-to-lymphocyte ratio (NLR) predicts adrenocortical carcinoma and is correlated with the prognosis

Cited by 19 publications

References 17 publications

Clinical Prognostic Factors in Patients With Metastatic Adrenocortical Carcinoma Treated With Second Line Gemcitabine Plus Capecitabine Chemotherapy

Clinical Prognostic Factors in Patients With Metastatic Adrenocortical Carcinoma Treated With Second Line Gemcitabine Plus Capecitabine Chemotherapy

Adrenal İnsidenteloma Olgularında Hemogram Parametrelerinin Değerlendirilmesi ve Klinik Önemi

Summary of clinical characteristics of common primary adrenal malignancies in adults

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