Julia Zaragoza1, Thibault Kervarrec2, Antoine Touzé3, Martine Avenel-Audran4, Nathalie Beneton5, Eric Esteve6, Ewa Wierzbicka Hainaut7, François Aubin8, Laurent Machet1, Mahtab Samimi9. 1. Department of Dermatology, Centre Hospitalier Universitaire Tours, Université François Rabelais, Tours, France. 2. Department of Pathology, Centre Hospitalier Universitaire Tours, Université François Rabelais, Tours, France. 3. Institut National de la Recherche Agronomique, Unité Mixte de Recherche 1282 Infectiologie et Santé Publique, Université François Rabelais, Tours, France. 4. Dermatology Department, Centre Hospitalier Universitaire Angers, L'Université Nantes Angers Le Mans (LUNAM), Angers, France. 5. Dermatology Department, Centre Hospitalier Régional Le Mans, Le Mans, France. 6. Dermatology Department, Centre Hospitalier Régional Orléans, Orléans, France. 7. Dermatology Department, Centre Hospitalier Universitaire Poitiers, Poitiers, France. 8. Dermatology Department, Centre Hospitalier Universitaire Besançon, Université de Franche Comté, Equipe d'Accueil 3181, Institut Fédératif de Recherche 133, Besançon, France. 9. Department of Dermatology, Centre Hospitalier Universitaire Tours, Université François Rabelais, Tours, France; Institut National de la Recherche Agronomique, Unité Mixte de Recherche 1282 Infectiologie et Santé Publique, Université François Rabelais, Tours, France. Electronic address: mahtab.samimi@univ-tours.fr.
Abstract
BACKGROUND: The prognostic relevance of a high blood neutrophil-to-lymphocyte ratio (NLR) has been reported in many cancers, although, to our knowledge, not investigated in patients with Merkel cell carcinoma (MCC) to date. OBJECTIVE: We assessed whether the NLR at baseline was associated with specific survival and recurrence-free survival in MCC. METHODS: We retrospectively included MCC cases between 1999 and 2015 and collected clinical data, blood cell count at baseline, and outcome. A Cox model was used to identify factors associated with recurrence and death from MCC. RESULTS: Among the 75 patients included in the study, a high NLR at baseline (NLR ≥4) was associated with death from MCC in univariate (hazard ratio 2.76, 95% confidence interval 1.15-6.62, P = .023) and multivariate (hazard ratio 3.30, 95% confidence interval 1.21-9.01, P = .020) analysis, but not with recurrence. LIMITATIONS: Because of the retrospective design, we excluded patients with missing data and not all confounding factors that may influence the NLR were available. CONCLUSION: A high NLR at baseline was independently associated with specific mortality in patients with MCC. The NLR seems to constitute an easily available and inexpensive prognostic biomarker at baseline.
BACKGROUND: The prognostic relevance of a high blood neutrophil-to-lymphocyte ratio (NLR) has been reported in many cancers, although, to our knowledge, not investigated in patients with Merkel cell carcinoma (MCC) to date. OBJECTIVE: We assessed whether the NLR at baseline was associated with specific survival and recurrence-free survival in MCC. METHODS: We retrospectively included MCC cases between 1999 and 2015 and collected clinical data, blood cell count at baseline, and outcome. A Cox model was used to identify factors associated with recurrence and death from MCC. RESULTS: Among the 75 patients included in the study, a high NLR at baseline (NLR ≥4) was associated with death from MCC in univariate (hazard ratio 2.76, 95% confidence interval 1.15-6.62, P = .023) and multivariate (hazard ratio 3.30, 95% confidence interval 1.21-9.01, P = .020) analysis, but not with recurrence. LIMITATIONS: Because of the retrospective design, we excluded patients with missing data and not all confounding factors that may influence the NLR were available. CONCLUSION: A high NLR at baseline was independently associated with specific mortality in patients with MCC. The NLR seems to constitute an easily available and inexpensive prognostic biomarker at baseline.
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