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High blood neutrophil-to-lymphocyte ratio is an indicator of poor prognosis in malignant mesothelioma patients undergoing systemic therapy.
- Source :
-
Clinical cancer research : an official journal of the American Association for Cancer Research [Clin Cancer Res] 2010 Dec 01; Vol. 16 (23), pp. 5805-13. Date of Electronic Publication: 2010 Oct 18. - Publication Year :
- 2010
-
Abstract
- Purpose: Asbestos-induced chronic inflammation is implicated in the pathogenesis of malignant mesothelioma (MM). We have investigated blood neutrophil-to-lymphocyte ratio (NLR), an index of systemic inflammation, as a prognostic factor in MM patients.<br />Experimental Design: Patients with MM who had systemic therapy at participating institutes were studied. Potential prognostic factors such as age, gender, performance status, histologic subtype, and baseline laboratory parameters, including NLR, were analyzed. Overall survival from commencement of therapy was determined by the Kaplan-Meier method. Multivariate analyses using Cox Regression model were performed with significant factors (P ≤ 0.05) to determine their independent effect.<br />Results: A total of 173 MM patients undergoing systemic therapy including 119 patients receiving first-line therapy and 54 patients receiving second- or third-line therapy were included in this retrospective evaluation. Forty-two percent of patients had an elevated NLR at baseline. The following variables were predictive of survival: female gender (P = 0.044), epithelioid histologic subtype (P < 0.001), baseline white blood cell count less than 8.3 × 10⁹/L (P = 0.008), baseline platelet count 400 × 10⁹/L or less (P = 0.05), and NLR of 5 or less (P < 0.001). After multivariate analysis, histologic epithelioid subtype [hazard ratio (HR) = 2.0; 95% confidence interval (CI) = 1.3-2.9; P = 0.001], and NLR less than 5 (HR = 2.7; 95% CI = 1.8-3.9; P < 0.001) remained independent predictors. The 1-year survival rate was 60% versus 26%, whereas the 2-year survival rate was 34% versus 10% for NLR less than 5 and 5 or greater, respectively. In the separate analyses of chemotherapy-naive and previously treated patient groups, NLR was an independent predictor of survival in both groups.<br />Conclusion: Our results indicate that NLR is an independent predictor of survival for patients with MM undergoing systemic therapy.<br /> (©2010 AACR.)
- Subjects :
- Adult
Aged
Algorithms
Female
Health Status Indicators
Humans
Leukocyte Count
Male
Mesothelioma mortality
Mesothelioma pathology
Middle Aged
Neoplasm Staging
Pleural Neoplasms mortality
Pleural Neoplasms pathology
Predictive Value of Tests
Prognosis
Retrospective Studies
Survival Analysis
Lymphocytes pathology
Mesothelioma diagnosis
Mesothelioma therapy
Neutrophils pathology
Pleural Neoplasms diagnosis
Pleural Neoplasms therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1557-3265
- Volume :
- 16
- Issue :
- 23
- Database :
- MEDLINE
- Journal :
- Clinical cancer research : an official journal of the American Association for Cancer Research
- Publication Type :
- Academic Journal
- Accession number :
- 20956618
- Full Text :
- https://doi.org/10.1158/1078-0432.CCR-10-2245