The Relation between Hemogram Parameters and Survival in Extensive-Stage Small Cell Lung Cancer

BackgroundThe neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) were analyzed in various carcinomas and their potential prognostic significance was determined. The objective of present study was to determine the correlation between these parameters and the survival of patients with small cell lung cancer (SCLC), since very few studies have been published on this type of carcinoma.Patients and methodsOne hundred and forty patients diagnosed with SCLC at University Hospital Center Zagreb, between 2012 and 2016 were retrospectively analyzed. Extensive-stage disease (ED) was verified in 80 patients and limited-stage disease (LD) in 60 patients. We analyzed the potential prognostic significance of various laboratory parameters, including NLR, PLR, and LMR, measured before the start of treatment.ResultsDisease extension, response to therapy, chest irradiation and prophylactic cranial irradiation (PCI), as well as hemoglobin, monocyte count, C-reactive protein (CRP), and lactate dehydrogenase (LDH) showed a prognostic significance in all patients. When we analyzed the patients separately, depending on the disease extension, we found that only skin metastases as well as LDH and NLR values, regardless of the cut-off value, had a prognostic significance in ED. Meanwhile, the ECOG performance status, chest irradiation, PCI, and hemoglobin and creatinine values had a prognostic significance in LD.ConclusionsNLR calculated before the start of the treatment had a prognostic significance for ED, while PLR and LMR had no prognostic significance in any of the analyzed groups of patients.

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“…The cut-off values for NLR were 4 and 5, those for PLR were 150 and 250, and those for LMR were 2.64 and 4.19. [34][35][36][37][38][39]…”

Section: Discussionmentioning

confidence: 99%

“…25,35,42 There are only two studies investigating the prognostic role of NLR and/or PLR exclusively in the ED group of patients. 34,43 To our knowledge, to date neither of these two parameters have been investigated on a European population in cases of extended SCLC.…”

Section: Discussionmentioning

confidence: 99%

Neutrophil-to-lymphocyte ratio can predict outcome in extensive-stage small cell lung cancer

Drpa

Šutić

Baranašić

et al. 2020

Radiology and Oncology

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“…1) The cut-off point, 6, of NLR in GRIm-score is much higher than those, 3 -4, of the previous studies that had detected NLR as a significant prognostic factor for SCLC [16][17][18].…”

Section: Discussionmentioning

confidence: 83%

Gustave Roussy Immune Score and Royal Marsden Hospital Prognostic Score Are Prognostic Markers for Extensive Disease of Small Cell Lung Cancer

2020

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Background: The Royal Marsden Hospital prognostic score (RMH score) and the Gustave Roussy immune score (GRIm-score) were developed in order to select more suitable patient for phase I trials. Lactate dehydrogenase (LDH) and serum albumin concentration are common risk factors to these two systems. As the third risk factor, the RMH score and the GRIm-score adopt number of metastatic sites and neutrophil-to-lymphocyte ratio (NLR), respectively. We aimed to investigate whether these two systems are also useful for extensive disease of small cell lung cancer (ED-SCLC). Methods: We retrospectively collected 128 patients who had initiated platinum-based chemotherapy at our hospital between September 2007 and March 2018. We divided our patients into low (score 0-1) and high (2-3) score groups, and compared overall survival (OS) and progression-free survival (PFS) between them. Multivariate Cox proportional hazard analyses found prognostic factors of survival times. Results: Regarding GRIm-score, OS was significantly shorter in high score group than in low score group (median 6.1 vs. 11.4 months, P < 0.01), while no significant difference was observed in PFS (median 4.7 vs. 5.0 months, P = 0.12). Both OS (median 6.9 vs. 12.4 months, P < 0.01) and PFS (median 4.4 vs. 5.4 months, P = 0.01) were significantly shorter in high RMH score group than in low group. Multivariate analyses detected both high GRIm-score (hazard ratio (HR) 1.80, 95% confidence interval (CI) 1.20-2.72, P < 0.01) and high RMH score (HR 1.93, 95% CI 1.27-2.92, P < 0.01) as independent worse prognostic factors of OS, and then only high RMH score (HR 1.53, 95% CI 1.04-2.25, P = 0.03) as independent worse prognostic factor of PFS. Conclusions: Both RMH score and GRIm-score are useful as independent prognostic factors of OS in ED-SCLC. However, only RMH score is an independent prognostic factor of PFS.

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“…For one study, the stage of disease was not described (42). The presence of liver metastasis was described in seven studies (21,29,30,34,46,48,51) ALI, advanced lung cancer in ammation index (body mass index x albumin / NLR )); ALP, alkaline phosphate); CT, chemotherapy; ECOG PS, Eastern Coopera status; HALP, haemoglobin × albumin × lymphocytes / platelet count; HGB, haemoglobin; KPS, Karnofsky performance scale; LDH, lactate dehydrogenase; LM M: multivariate; MCV, mean cell volume; MLR, monocyte-to-lymphocyte ratio; mGPS, modi ed Glasgow Prognostic Score (CRP ≤ 10 mg/L and albumin ≥ 35 g 35 g/L: score 1; CRP < 10 mg/L and ≤ 35 g/L: score 1; CRP > 10 mg/L and albumin < 35 g/L: score 2) ; MPV, mean platelet volume; PCI, prophylactic cranial ir lymphocyte ratio; PNI, prognostic nutritional index; RBC, red blod cell count; RT: radiotherapy; SII, systemic immune-in ammation index (= platelet count × neu TCR, thoracic chemo-radiotherapy; U: univariate.…”

Section: Study Description and Quality Assessmentmentioning

confidence: 99%

“…In the identi ed 33 studies, an adjusted risk estimate of mortality risk between patients with a low versus a high score could only be retrieved in 25 studies (NLR: 16 (17,21,22,24,25,29,32,35,41,(43)(44)(45)(46)(49)(50)(51), PLR: 7 (24,25,34,37,41,50,51), LMR: 2 (21,41), MLR: 2 (46,47), mGPS:4 (28,30,34,39), SII: 3 (24,40,41), ALI:1 (23,26)). Rating and adjustment variables for the individual study are listed in Table 1.…”

Section: In Ammation Scores and Overall Survivalmentioning

confidence: 99%

Inflammation Scores as Prognostic Biomarkers in Small Cell Lung Cancer: A Systematic Review and Meta-Analysis

Winther‐Larsen

Aggerholm‐Pedersen

Sandfeld-Paulsen

2020

Preprint

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Background: Inflammation scores based on general inflammation markers as leucocyte count or C-reactive protein have been evaluated as prognostic markers of inferior survival in several cancers. In small cell lung cancer (SCLC), however, inflammation scores are less studied. In the present study, we set out to perform a systematic review and meta-analysis investigating reported associations between inflammation scores and overall survival (OS) in SCLC. Methods: A literature search was performed in PubMed, Embase, Scopus, and Web of Science following the Preferred Reporting Items for Systematic and Meta-Analyses (PRISMA) guidelines. Of the identified publications, only studies in English containing original data evaluating inflammation scores as a prognostic factor in SCLC patients were included. Hazard ratios (HRs) for OS were pooled in a random-effects model. Results: In total, 33 articles were included evaluating eight different inflammation scores in 7762 SCLC patients. Seven of the identified scores were based on leucocyte count. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte (PLR) ratio were the most frequently evaluated scores (NLR: n=23; PLR: n=22). For NLR, a meta-analysis including 16 studies demonstrated that patients with a high NLR had a significantly shorter OS compared to patients with a low NLR (pooled HR=1.39 (95 % CI, 1.23 – 1.56)). For PLR, an association with survival could not be confirmed in a meta-analysis performed based on eight studies (pooled HR=1.20 (95 % CI, 0.96 – 1.51)). Conclusions: This review identifies that inflammation scores based on general inflammation markers have some potential as prognostic biomarkers in SCLC. The meta-analyses indicated that NLR is associated with inferior OS, whereas an association between PLR and OS could not be confirmed. Thus, NLR could be a useful biomarker of OS in SCLC patients. Systematic Review Registrations: The protocol for the study was submitted to the PROSPERO database (registration number CRD42020188553).

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The Relation between Hemogram Parameters and Survival in Extensive-Stage Small Cell Lung Cancer

Cited by 18 publications

References 27 publications

Neutrophil-to-lymphocyte ratio can predict outcome in extensive-stage small cell lung cancer

Neutrophil-to-lymphocyte ratio can predict outcome in extensive-stage small cell lung cancer

Gustave Roussy Immune Score and Royal Marsden Hospital Prognostic Score Are Prognostic Markers for Extensive Disease of Small Cell Lung Cancer

Inflammation Scores as Prognostic Biomarkers in Small Cell Lung Cancer: A Systematic Review and Meta-Analysis

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