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

Kang, Myoung Hee; Go, Se‐Il; Song, Haa‐Na; Lee, A.; Kim, S. H.; Kang, Jung Hun; Jeong, Bae Kwon; Kang, Kyung‐Hwa; Ling, Hui; Lee, G. W.

doi:10.1038/bjc.2014.317

Cited by 179 publications

(157 citation statements)

References 43 publications

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“…PNI is not commonly used as a score for the measurement of systemic inflammatory responses, and a study of hepatocellular carcinoma (HCC) found that PNI was an independent and externally validated predictor of poor OS in patients with HCC (Pinato et al 2012). Only two studies have focused on the value of NLR for prognosis in SCLC, with the results indicating that elevated NLR could predict worse OS and PFS (Kang et al 2014;Wang et al 2014). There is, therefore, a lack of data from studies with adequate sample sizes and multiple inflammation-based scores.…”

Section: Discussionmentioning

confidence: 99%

Systemic Immune-inflammation Index, Based on Platelet Counts and Neutrophil-Lymphocyte Ratio, Is Useful for Predicting Prognosis in Small Cell Lung Cancer

Hong

Cui

Wang

et al. 2015

Tohoku J. Exp. Med.

267

239

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Small cell lung cancer (SCLC) is an aggressive disease characterized by rapid growth and metastases. It has been recognized that the inflammation of the microenvironment plays a critical role in the development of malignancies. However, little is known about the role of multiple inflammatory and hematological markers in the prognosis of SCLC. The aim of this study was to determine the clinical significance of pre-treatment inflammation-based scores and characteristics as prognostic indicators for the survival of SCLC patients. A retrospective analysis of 919 SCLC cases was performed. Patients' characteristics and hematologic tests data at initial diagnosis were collected. The univariate analysis of all SCLC patients indicated that favorable prognostic factors were age ˂ 70 years, non-smokers, good performance status, limited disease and response to treatment. Moreover, univariate analysis of inflammation-based scores and other blood parameters showed that neutrophil-lymphocyte ratio ≥ 5, platelet-lymphocyte ratio ≥ 250, systemic immune-inflammation index (SII) ≥ 1,600 × 10 9 /L, prognostic nutritional index (albumin + 5 × lymphocyte) < 45, and elevated serum lactate dehydrogenase (LDH) predicted poor prognosis in SCLC patients. SII represents the score that is calculated as follows: platelet count × neutrophil count/lymphocyte count. In the multivariate analysis, SII, together with serum LDH, stage and response to therapy, were associated with overall survival (OS). This study demonstrated that the combination of platelet count and neutrophil-lymphocyte ratio could help to predict poor prognosis in SCLC. Our findings will facilitate the understanding of survival differences in SCLC patients in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Systemic Immune-inflammation Index, Based on Platelet Counts and Neutrophil-Lymphocyte Ratio, Is Useful for Predicting Prognosis in Small Cell Lung Cancer

Hong

Cui

Wang

et al. 2015

Tohoku J. Exp. Med.

267

239

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“…Consistent with previous studies of advanced cancers, elevated NLR was a strong prognostic factor. 4,8,11,13,14,16,19,22,27,34 The role of the host inflammatory response in determining tumor spread is increasingly recognized. The association between elevated NLR and poor prognosis has several possible explanations.…”

Section: Figmentioning

confidence: 99%

“…15,35 A systematic inflammatory response leads to changes in the relative levels of circulating white blood cells, resulting in an increase in neutrophils and a decrease in lymphocytes with the progression of cancer. 25 Recently, an association was reported between a high neutrophil-to-lymphocyte ratio (NLR) and shorter survival time in patients with various cancers, 4,8,11,13,14,16,19,22,27,34 including glioblastoma. 3,12,18 However, the value of preoperative NLR in the assessment of candidates for resection for brain metastasis has not been evaluated.…”

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confidence: 99%

Elevated preoperative neutrophil-to-lymphocyte ratio as a predictor of worse survival after resection in patients with brain metastasis

Mitsuya¹,

Nakasu²,

Kurakane

et al. 2017

Journal of Neurosurgery

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B rain metastases occur in 10% to 40% of patients with cancer and are the most common central nervous system neoplasm in adults. 28,33 With increased surveillance, improved control of systemic cancer, and prolonged survival, the incidence of patients with brain metastases is increasing. 17 The management of brain metastases has been revolutionized in clinical oncology by 4 developments: improved brain imaging, improved management of systemic diseases, the distribution of stereotactic irradiation, and the extension of less invasive surgical techniques that enable brain metastases to be removed even from eloquent brain areas with minimal morbidity. 5Although stereotactic irradiation and pharmacotherapies contribute to the treatment outcome of patients with brain metastasis, resection is still a mainstay for large brain metastases.The indications for resection include a symptomatic mass, a mass with considerable edema requiring high-dose ABBREVIATIONS DS-GPA = diagnosis-specific graded prognostic assessment; KPS = Karnofsky Performance Status; NLR = neutrophil-to-lymphocyte ratio; OS = overall survival; RPA = recursive partitioning analysis. SUBMITTED OBJECTIVEThe median postoperative survival duration of patients with brain metastases who undergo tumor resection is 12 months. Most of these patients die of systemic metastases or the progression of primary cancer but not brain metastases. The criteria for indicating resection are still controversial. Systemic assessment is restricted, especially in patients who need emergent management for their large-size or life-threatening brain metastases. The neutrophil-tolymphocyte ratio (NLR) is reported to correlate with survival time or progression-free survival in patients with various cancers. However, NLR has not been assessed in patients with brain metastases. The impact of NLR on the survival data of patients who had undergone resection of brain metastases was retrospectively analyzed. METHODS The clinical records of patients who underwent resection of brain metastases at Shizuoka Cancer Center between May 2007 and January 2015 were retrospectively analyzed. NLR was calculated by using the data obtained from the latest examination before resection and before the administration of steroid therapy. Kaplan-Meier curves were used for the assessment of overall survival (OS). RESULTS Of the 105 patients included, 67 patients were male. The median age of the patients was 63 years (range 36-90 years). The primary cancers were lung, colon, breast, uterus, and other cancers in 48, 19, 10, 8, and 20 patients, respectively. The postresection median survival duration was 12 months (range 1-91 months) for the entire series. The optimum NLR threshold value was identified as 5. A significant difference in the median OS was found: 14 months for 82 patients with an NLR < 5 versus 5 months for 23 patients with an NLR ≥ 5 (p = 0.001). CONCLUSIONS In this study, an elevated preoperative NLR is a predictor of worse survival after resection for brain metastases. NLR is a simple, systemic m...

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“…Therefore, it is not surprising that neutrophils, a key inflammatory cell type, can be mobilized and recruited to tumors. In fact, aberrant accumulation of neutrophils has been documented in a wide variety of tumors and is often associated with poor clinical outcomes (4)(5)(6)(7)(8)(9)(10)(11). Emerging evidence also suggests that neutrophils, in response to signals derived from cancer cells or stromal cells, can alter their phenotypes and migration routes and also release factors that act on tumor cells and other cell types (e.g., endothelial cells and immune cells), which we review in the following sections.…”

Section: Introductionmentioning

confidence: 99%

The Complex Role of Neutrophils in Tumor Angiogenesis and Metastasis

Liang

Ferrara

2016

Cancer Immunology Research

292

224

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Chronic inflammation fosters cancer development and progression and also modulates tumor responses to anticancer therapies. Neutrophils are key effector cells in innate immunity and are known to play a critical role in various inflammatory disorders. However, the functions of neutrophils in cancer pathogenesis have been largely neglected until recently and still remain poorly characterized compared with other immune cells in the tumor microenvironment. We highlight recent findings on the mechanisms by which tumor cells, in cooperation with tumorassociated stromal cells, induce expansion, recruitment, and polarization of neutrophils. We also review the multifaceted roles that neutrophils play in different aspects of cancer development and progression, with an emphasis on tumor angiogenesis and metastasis.

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

Cited by 179 publications

References 43 publications

Systemic Immune-inflammation Index, Based on Platelet Counts and Neutrophil-Lymphocyte Ratio, Is Useful for Predicting Prognosis in Small Cell Lung Cancer

Systemic Immune-inflammation Index, Based on Platelet Counts and Neutrophil-Lymphocyte Ratio, Is Useful for Predicting Prognosis in Small Cell Lung Cancer

Elevated preoperative neutrophil-to-lymphocyte ratio as a predictor of worse survival after resection in patients with brain metastasis

The Complex Role of Neutrophils in Tumor Angiogenesis and Metastasis

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