Joanna Szkandera1, Armin Gerger2, Bernadette Liegl-Atzwanger3, Michael Stotz2, Hellmut Samonigg4, Joerg Friesenbichler5, Tatjana Stojakovic6, Andreas Leithner5, Martin Pichler4. 1. Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria; Research Unit Genetic Epidemiology and Pharmacogenetics, Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria. Electronic address: joanna.szkandera@medunigraz.at. 2. Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria; Research Unit Genetic Epidemiology and Pharmacogenetics, Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria. 3. Institute of Pathology, Medical University of Graz, Graz, Austria. 4. Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria. 5. Department of Orthopaedic Surgery, Medical University of Graz, Graz, Austria. 6. Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
Abstract
BACKGROUND: Inflammation plays an important role in tumor proliferation and survival in cancer patients. The aim of this study was to investigate the prognostic impact of the pre-operative-derived neutrophil/lymphocyte ratio (dNLR) in a large cohort of soft tissue sarcoma (STS) patients after curative surgical resection. METHODS: The impact of preoperative dNLR on disease-free survival (DFS) and overall survival (OS) in retrospectively evaluated 340 STS patients was assessed using Kaplan-Meier curves and Cox proportional models. RESULTS: Applying receiver operating curve analysis, we determined a cut-off value of 2.39 for the dNLR to be optimal for discrimination of patients' survival in the whole cohort. Kaplan-Meier curves revealed a dNLR greater than or equal to 2.39 as a marker for decreased DFS (P = .031) and OS (P = .007, log-rank test) in STS patients. In multivariate analysis, increased dNLR was significantly associated with poor OS (hazard ratio 1.60, 95% confidence interval 1.07 to 2.40, P = .022). CONCLUSIONS: This study demonstrates that preoperative dNLR might represent a well-correlated surrogate marker for the widely validated NLR. The dNLR is easily obtainable and can provide important information for individual risk assessment in clinical trials.
BACKGROUND: Inflammation plays an important role in tumor proliferation and survival in cancerpatients. The aim of this study was to investigate the prognostic impact of the pre-operative-derived neutrophil/lymphocyte ratio (dNLR) in a large cohort of soft tissue sarcoma (STS) patients after curative surgical resection. METHODS: The impact of preoperative dNLR on disease-free survival (DFS) and overall survival (OS) in retrospectively evaluated 340 STS patients was assessed using Kaplan-Meier curves and Cox proportional models. RESULTS: Applying receiver operating curve analysis, we determined a cut-off value of 2.39 for the dNLR to be optimal for discrimination of patients' survival in the whole cohort. Kaplan-Meier curves revealed a dNLR greater than or equal to 2.39 as a marker for decreased DFS (P = .031) and OS (P = .007, log-rank test) in STS patients. In multivariate analysis, increased dNLR was significantly associated with poor OS (hazard ratio 1.60, 95% confidence interval 1.07 to 2.40, P = .022). CONCLUSIONS: This study demonstrates that preoperative dNLR might represent a well-correlated surrogate marker for the widely validated NLR. The dNLR is easily obtainable and can provide important information for individual risk assessment in clinical trials.
Authors: Florian Posch; Richard Partl; Carmen Döller; Jakob M Riedl; Maria Smolle; Lukas Leitner; Marko Bergovec; Bernadette Liegl-Atzwanger; Michael Stotz; Angelika Bezan; Armin Gerger; Martin Pichler; Karin S Kapp; Herbert Stöger; Andreas Leithner; Joanna Szkandera Journal: Ann Surg Oncol Date: 2017-09-11 Impact factor: 5.344