Neutrophil-lymphocyte ratio is prognostic in early stage resected small-cell lung cancer

Zoltan Lohinai, Laura Bonanno, Aleksei Aksarin, Alberto Pavan, Zsolt Megyesfalvi, Balazs Santa, Virag Hollosi, Balazs Hegedus, Judit Moldvay, Pier Franco Conte, Mikhail Ter-Ovanesov, Evgeniy Bilan, Balazs Dome, Glen J. Weiss

Research output: Contribution to journalArticle

Abstract

Background: For selected early stage small cell lung cancer (SCLC), curative intent surgery is often performed. Previous studies, predominantly from East Asia, reported that high neutrophil to lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) correlate with poor prognosis in several types of tumors including SCLC. Our aim was to investigate the prognostic value of NLR and PLR in Caucasian patients with resected SCLC, as potential tool to select patients for multimodal treatment including surgery. Methods: Consecutive patients evaluated at three centers between 2000 and 2013 with histologically confirmed and surgically resected SCLC were retrospectively analyzed. NLR and PLR at diagnosis was used to categorize patients into "high" and "low" groups based on receiver operating curve analysis. Univariate and multivariate analyses were used to evaluate the impact of clinical and pathological characteristics on outcome. Results: There were a total of 189 patients with a median age of 58 years, and the majority had stage I or II disease. We found a significant correlation between NLR and tumor stage (p = 0.007) and age (p = 0.038). Low NLR (LNLR) was associated with significantly longer overall survival, while PLR had no prognostic impact. There were significant associations between NLR and PLR but not with gender, vascular involvement, tumor necrosis, peritumoral inflammation, or tumor grade. Conclusion: Pre-operative LNLR may be a favorable prognostic factor in stage I-II SCLCs. PLR is not prognostic in this population. LNLR is easy to assess and can be integrated into routine clinical practice. Further prospective studies are needed to confirm these observations.

Original languageEnglish
JournalPeerJ
Volume2019
Issue number7
DOIs
Publication statusPublished - Jan 1 2019

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Lymphocytes
Small Cell Lung Carcinoma
lung neoplasms
neutrophils
Neutrophils
lymphocytes
Cells
Platelets
Blood Platelets
cells
Tumors
neoplasms
Surgery
Neoplasms
surgery
Combined Modality Therapy
Far East
prospective studies
East Asia
blood vessels

Keywords

  • Early stage small cell lung cancer
  • Neutrophil-lymphocyte ratio
  • Platelet-lymphocyte ratio
  • Surgery

ASJC Scopus subject areas

  • Neuroscience(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Lohinai, Z., Bonanno, L., Aksarin, A., Pavan, A., Megyesfalvi, Z., Santa, B., ... Weiss, G. J. (2019). Neutrophil-lymphocyte ratio is prognostic in early stage resected small-cell lung cancer. PeerJ, 2019(7). https://doi.org/10.7717/peerj.7232

Neutrophil-lymphocyte ratio is prognostic in early stage resected small-cell lung cancer. / Lohinai, Zoltan; Bonanno, Laura; Aksarin, Aleksei; Pavan, Alberto; Megyesfalvi, Zsolt; Santa, Balazs; Hollosi, Virag; Hegedus, Balazs; Moldvay, Judit; Conte, Pier Franco; Ter-Ovanesov, Mikhail; Bilan, Evgeniy; Dome, Balazs; Weiss, Glen J.

In: PeerJ, Vol. 2019, No. 7, 01.01.2019.

Research output: Contribution to journalArticle

Lohinai, Z, Bonanno, L, Aksarin, A, Pavan, A, Megyesfalvi, Z, Santa, B, Hollosi, V, Hegedus, B, Moldvay, J, Conte, PF, Ter-Ovanesov, M, Bilan, E, Dome, B & Weiss, GJ 2019, 'Neutrophil-lymphocyte ratio is prognostic in early stage resected small-cell lung cancer', PeerJ, vol. 2019, no. 7. https://doi.org/10.7717/peerj.7232
Lohinai Z, Bonanno L, Aksarin A, Pavan A, Megyesfalvi Z, Santa B et al. Neutrophil-lymphocyte ratio is prognostic in early stage resected small-cell lung cancer. PeerJ. 2019 Jan 1;2019(7). https://doi.org/10.7717/peerj.7232
Lohinai, Zoltan ; Bonanno, Laura ; Aksarin, Aleksei ; Pavan, Alberto ; Megyesfalvi, Zsolt ; Santa, Balazs ; Hollosi, Virag ; Hegedus, Balazs ; Moldvay, Judit ; Conte, Pier Franco ; Ter-Ovanesov, Mikhail ; Bilan, Evgeniy ; Dome, Balazs ; Weiss, Glen J. / Neutrophil-lymphocyte ratio is prognostic in early stage resected small-cell lung cancer. In: PeerJ. 2019 ; Vol. 2019, No. 7.
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abstract = "Background: For selected early stage small cell lung cancer (SCLC), curative intent surgery is often performed. Previous studies, predominantly from East Asia, reported that high neutrophil to lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) correlate with poor prognosis in several types of tumors including SCLC. Our aim was to investigate the prognostic value of NLR and PLR in Caucasian patients with resected SCLC, as potential tool to select patients for multimodal treatment including surgery. Methods: Consecutive patients evaluated at three centers between 2000 and 2013 with histologically confirmed and surgically resected SCLC were retrospectively analyzed. NLR and PLR at diagnosis was used to categorize patients into {"}high{"} and {"}low{"} groups based on receiver operating curve analysis. Univariate and multivariate analyses were used to evaluate the impact of clinical and pathological characteristics on outcome. Results: There were a total of 189 patients with a median age of 58 years, and the majority had stage I or II disease. We found a significant correlation between NLR and tumor stage (p = 0.007) and age (p = 0.038). Low NLR (LNLR) was associated with significantly longer overall survival, while PLR had no prognostic impact. There were significant associations between NLR and PLR but not with gender, vascular involvement, tumor necrosis, peritumoral inflammation, or tumor grade. Conclusion: Pre-operative LNLR may be a favorable prognostic factor in stage I-II SCLCs. PLR is not prognostic in this population. LNLR is easy to assess and can be integrated into routine clinical practice. Further prospective studies are needed to confirm these observations.",
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AU - Lohinai, Zoltan

AU - Bonanno, Laura

AU - Aksarin, Aleksei

AU - Pavan, Alberto

AU - Megyesfalvi, Zsolt

AU - Santa, Balazs

AU - Hollosi, Virag

AU - Hegedus, Balazs

AU - Moldvay, Judit

AU - Conte, Pier Franco

AU - Ter-Ovanesov, Mikhail

AU - Bilan, Evgeniy

AU - Dome, Balazs

AU - Weiss, Glen J.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: For selected early stage small cell lung cancer (SCLC), curative intent surgery is often performed. Previous studies, predominantly from East Asia, reported that high neutrophil to lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) correlate with poor prognosis in several types of tumors including SCLC. Our aim was to investigate the prognostic value of NLR and PLR in Caucasian patients with resected SCLC, as potential tool to select patients for multimodal treatment including surgery. Methods: Consecutive patients evaluated at three centers between 2000 and 2013 with histologically confirmed and surgically resected SCLC were retrospectively analyzed. NLR and PLR at diagnosis was used to categorize patients into "high" and "low" groups based on receiver operating curve analysis. Univariate and multivariate analyses were used to evaluate the impact of clinical and pathological characteristics on outcome. Results: There were a total of 189 patients with a median age of 58 years, and the majority had stage I or II disease. We found a significant correlation between NLR and tumor stage (p = 0.007) and age (p = 0.038). Low NLR (LNLR) was associated with significantly longer overall survival, while PLR had no prognostic impact. There were significant associations between NLR and PLR but not with gender, vascular involvement, tumor necrosis, peritumoral inflammation, or tumor grade. Conclusion: Pre-operative LNLR may be a favorable prognostic factor in stage I-II SCLCs. PLR is not prognostic in this population. LNLR is easy to assess and can be integrated into routine clinical practice. Further prospective studies are needed to confirm these observations.

AB - Background: For selected early stage small cell lung cancer (SCLC), curative intent surgery is often performed. Previous studies, predominantly from East Asia, reported that high neutrophil to lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) correlate with poor prognosis in several types of tumors including SCLC. Our aim was to investigate the prognostic value of NLR and PLR in Caucasian patients with resected SCLC, as potential tool to select patients for multimodal treatment including surgery. Methods: Consecutive patients evaluated at three centers between 2000 and 2013 with histologically confirmed and surgically resected SCLC were retrospectively analyzed. NLR and PLR at diagnosis was used to categorize patients into "high" and "low" groups based on receiver operating curve analysis. Univariate and multivariate analyses were used to evaluate the impact of clinical and pathological characteristics on outcome. Results: There were a total of 189 patients with a median age of 58 years, and the majority had stage I or II disease. We found a significant correlation between NLR and tumor stage (p = 0.007) and age (p = 0.038). Low NLR (LNLR) was associated with significantly longer overall survival, while PLR had no prognostic impact. There were significant associations between NLR and PLR but not with gender, vascular involvement, tumor necrosis, peritumoral inflammation, or tumor grade. Conclusion: Pre-operative LNLR may be a favorable prognostic factor in stage I-II SCLCs. PLR is not prognostic in this population. LNLR is easy to assess and can be integrated into routine clinical practice. Further prospective studies are needed to confirm these observations.

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KW - Neutrophil-lymphocyte ratio

KW - Platelet-lymphocyte ratio

KW - Surgery

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