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Comparison of neutrophil to lymphocyte ratio and prognostic nutritional index with other clinical and molecular biomarkers for prediction of glioblastoma multiforme outcome
- Source :
- PLoS ONE, Vol 16, Iss 6, p e0252614 (2021), PLoS ONE
- Publication Year :
- 2021
- Publisher :
- Public Library of Science (PLoS), 2021.
-
Abstract
- Objective Pre- and post-operative neutrophil to lymphocyte ratio (NLR) and prognostic nutritional index (PNI) and other prognostic clinicopathological variables were correlated with progression free survival (PFS) and overall survival (OS) of Glioblastoma Multiforme (GBM) patients. Methods GBM patients (n = 87, single-centre, recruited 2013–2019) were retrospectively divided into low and high groups using literature-derived cut-offs (NLR = 5.07, PNI = 46.97). Kaplan-Meier survival curves and log rank tests assessed PFS and OS. Univariate and multivariate analyses identified PFS and OS prognosticators. Results High vs low post-operative PNI cohort was associated with longer PFS (279 vs 136 days, p = 0.009), but significance was lost on multivariate analysis. Post-operative ECOG (p = 0.043), daily dexamethasone (p = 0.023) and IDH mutation (p = 0.046) were significant on multivariate analysis for PFS. High pre- and post-operative PNI were associated with improved OS (384 vs 114 days, p = 0.034 and 516 vs 245 days, p = 0.001, respectively). Low postoperative NLR correlated with OS (408 vs 249 days, p = 0.029). On multivariate analysis using forward selection process, extent of resection (EOR) (GTR vs biopsy, p = 0.004 and STR vs biopsy, p = 0.011), and any previous surgery (p = 0.014) were independent prognostic biomarkers for OS. On multivariate analysis of these latter variables with literature-derived prognostic biomarkers, EOR remained significantly associated with OS (p = 0.037). Conclusions EOR, followed by having any surgery prior to GBM, are the most significant independent predictors of GBM patient’s OS. Post-operative ECOG, daily dexamethasone and IDH mutation are independent prognostic biomarkers for PFS. PNI may be superior to NLR. Post- vs pre-operative serum inflammatory marker levels may be associated with survival.
- Subjects :
- Male
Oncology
Multivariate analysis
Neutrophils
Cancer Treatment
Kaplan-Meier Estimate
Biochemistry
Dexamethasone
Mathematical and Statistical Techniques
Surgical oncology
Medicine and Health Sciences
Lymphocytes
Immune Response
Neurological Tumors
Multidisciplinary
medicine.diagnostic_test
Brain Neoplasms
Statistics
Middle Aged
Tumor Resection
Prognosis
Isocitrate Dehydrogenase
Progression-Free Survival
Surgical Oncology
Neurology
Physical Sciences
Medicine
Female
Research Article
medicine.drug
Clinical Oncology
medicine.medical_specialty
Blastoma
Science
Immunology
Nutritional Status
Surgical and Invasive Medical Procedures
Research and Analysis Methods
Signs and Symptoms
Internal medicine
Biopsy
Biomarkers, Tumor
medicine
Humans
Progression-free survival
Statistical Methods
Neutrophil to lymphocyte ratio
Survival analysis
Aged
Retrospective Studies
Inflammation
Surgical Resection
business.industry
Biology and Life Sciences
Cancers and Neoplasms
Log-rank test
Multivariate Analysis
Mutation
Clinical Medicine
Glioblastoma
business
Mathematics
Biomarkers
Glioblastoma Multiforme
Subjects
Details
- ISSN :
- 19326203
- Volume :
- 16
- Database :
- OpenAIRE
- Journal :
- PLOS ONE
- Accession number :
- edsair.doi.dedup.....6ff57ec425ed5c3879a59f9c620e5d60