Agnish Nayak1, Dermot T McDowell2,3, Stewart J Kellie2,4, Jonathan Karpelowsky5,6,7. 1. Faculty of Medicine, University of New South Wales, New South Wales, Australia. 2. Division of Child and Adolescent Health, Sydney Medical School, The University of Sydney, New South Wales, Australia. 3. Department of Paediatric Surgery, The Children's Hospital at Westmead, Westmead, Australia. 4. Children's Cancer Centre, The Children's Hospital at Westmead, Westmead, Australia. 5. Division of Child and Adolescent Health, Sydney Medical School, The University of Sydney, New South Wales, Australia. jonathan.karpelowsky@health.nsw.gov.au. 6. Department of Paediatric Surgery, The Children's Hospital at Westmead, Westmead, Australia. jonathan.karpelowsky@health.nsw.gov.au. 7. Children's Cancer Research Unit, Kids Research Institute, Westmead, Australia. jonathan.karpelowsky@health.nsw.gov.au.
Abstract
BACKGROUND: An elevated neutrophil-lymphocyte ratio (NLR) has been shown to indicate poorer prognosis for adults with solid tumors and potentially represents an independent, universal adjunct prognostic factor. The value of NLR in a pediatric setting has not been evaluated. This study sought to determine the prognostic value of NLR for pediatric patients with solid tumors. METHODS: Pediatric patients with solid tumors undergoing neoadjuvant chemotherapy followed by surgery with curative intent between 2000 and 2014 were eligible for this study. A preoperative peripheral blood count within 1 month of surgery taken after recovery from recent chemotherapy was analyzed in relation to overall survival (OS) and event-free survival (EFS). RESULTS: This retrospective study enrolled 293 patients. The median age at diagnosis was 46.5 months (range 0.1-206.1 months). Males accounted for 58% of the patients. The median OS was 49 months. An NLR cutoff of 2.5 was used in the analysis. In the univariate analysis, a high NLR was associated with low OS (p = 0.001) and low EFS (p = 0.020). Other factors identified in the univariate analysis that affected survival included metastatic disease at diagnosis (p < 0.001) and tumor type (p = 0.012). The multivariate analyses showed that a high NLR was associated with low OS (p = 0.014) but not with EFS (p = 0.270). The multivariate analysis of neuroblastoma patients found that a high NLR was associated with low OS (p = 0.013). CONCLUSIONS: An elevated NLR is prognostic of a poorer outcome for pediatric patients with solid tumors and potentially represents an independent, universal adjunct prognosticator in such cases.
BACKGROUND: An elevated neutrophil-lymphocyte ratio (NLR) has been shown to indicate poorer prognosis for adults with solid tumors and potentially represents an independent, universal adjunct prognostic factor. The value of NLR in a pediatric setting has not been evaluated. This study sought to determine the prognostic value of NLR for pediatric patients with solid tumors. METHODS: Pediatric patients with solid tumors undergoing neoadjuvant chemotherapy followed by surgery with curative intent between 2000 and 2014 were eligible for this study. A preoperative peripheral blood count within 1 month of surgery taken after recovery from recent chemotherapy was analyzed in relation to overall survival (OS) and event-free survival (EFS). RESULTS: This retrospective study enrolled 293 patients. The median age at diagnosis was 46.5 months (range 0.1-206.1 months). Males accounted for 58% of the patients. The median OS was 49 months. An NLR cutoff of 2.5 was used in the analysis. In the univariate analysis, a high NLR was associated with low OS (p = 0.001) and low EFS (p = 0.020). Other factors identified in the univariate analysis that affected survival included metastatic disease at diagnosis (p < 0.001) and tumor type (p = 0.012). The multivariate analyses showed that a high NLR was associated with low OS (p = 0.014) but not with EFS (p = 0.270). The multivariate analysis of neuroblastomapatients found that a high NLR was associated with low OS (p = 0.013). CONCLUSIONS: An elevated NLR is prognostic of a poorer outcome for pediatric patients with solid tumors and potentially represents an independent, universal adjunct prognosticator in such cases.
Authors: Vidal M Arroyo; Philip J Lupo; Michael E Scheurer; Surya P Rednam; Jeffrey Murray; M Fatih Okcu; Murali M Chintagumpala; Austin L Brown Journal: Cancer Epidemiol Date: 2019-01-29 Impact factor: 2.984
Authors: Monika Scheer; Christian Vokuhl; Bernd Blank; Erika Hallmen; Thekla von Kalle; Marc Münter; Rüdiger Wessalowski; Maite Hartwig; Monika Sparber-Sauer; Paul-Gerhardt Schlegel; Christof M Kramm; Udo Kontny; Bernd Spriewald; Thomas Kegel; Sebastian Bauer; Bernarda Kazanowska; Felix Niggli; Ruth Ladenstein; Gustaf Ljungman; Kirsi Jahnukainen; Jörg Fuchs; Stefan S Bielack; Thomas Klingebiel; Ewa Koscielniak Journal: Cancer Med Date: 2019-01-16 Impact factor: 4.452