Jianyang Wang1, Zhouguang Hui2, Yu Men2, Jingjing Kang1, Xin Sun1, Lei Deng1, Yirui Zhai1, Wenqing Wang1, Nan Bi1, Jun Liang1, Jima Lv1, Zongmei Zhou1, Qinfu Feng1, Zefen Xiao1, Dongfu Chen1, Luhua Wang1, Jun Zhao3. 1. Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, P.R. China. 2. Department of VIP Medical Services, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, P.R. China. 3. Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, P.R. China. Electronic address: drzhaojun@126.com.
Abstract
BACKGROUND: Systematic inflammation-immune status has been thought to play a crucial role in tumorigenesis and progress. This study evaluated the prognostic value of systematic inflammation-immune status in patients with resected non-small cell lung cancer with pathological N2 nodal involvement (pN2-NSCLC). METHODS: The relation between the preoperative systematic inflammation-immune score (SIS), defined as preoperative peripheral platelet count × neutrophil count/lymphocyte count, and prognosis was tested in a retrospective study of 660 consecutive patients with completed resected pN2-NSCLC and validated by a prospective study of 189 patients enrolled (NCT00880971). RESULTS: SIS of 650 × 109 was an optimal cutoff point to stratify the patients with pN2-NSCLC into high (>650 × 109) and low (≤650 × 109) SIS groups in the training cohort. Univariate and multivariate analyses revealed that the SIS was an independent predictor for overall survival, disease-free survival, and distant metastasis-free survival. In the validation group, high SIS (>650 × 109) predicted poor 5-year overall survival (hazard ratio [HR], 2.418; P = .006), disease-free survival (HR, 1.542; P = .042), and distant metastasis-free survival (HR, 1.682; P = .024). In addition to the number of positive lymph nodes, the area under the receiver operating characteristic curve of the SIS for outcomes was higher than the neutrophil count-to-lymphocyte count ratio, platelet count-to-lymphocyte count ratio, and other conventional clinicopathologic indices. CONCLUSIONS: The preoperative SIS is a more sensitive survival predictor than most of the other conventional clinical indices and may aid in more accurately stratifying patients for risk assessment and treatment decision.
BACKGROUND: Systematic inflammation-immune status has been thought to play a crucial role in tumorigenesis and progress. This study evaluated the prognostic value of systematic inflammation-immune status in patients with resected non-small cell lung cancer with pathological N2 nodal involvement (pN2-NSCLC). METHODS: The relation between the preoperative systematic inflammation-immune score (SIS), defined as preoperative peripheral platelet count × neutrophil count/lymphocyte count, and prognosis was tested in a retrospective study of 660 consecutive patients with completed resected pN2-NSCLC and validated by a prospective study of 189 patients enrolled (NCT00880971). RESULTS: SIS of 650 × 109 was an optimal cutoff point to stratify the patients with pN2-NSCLC into high (>650 × 109) and low (≤650 × 109) SIS groups in the training cohort. Univariate and multivariate analyses revealed that the SIS was an independent predictor for overall survival, disease-free survival, and distant metastasis-free survival. In the validation group, high SIS (>650 × 109) predicted poor 5-year overall survival (hazard ratio [HR], 2.418; P = .006), disease-free survival (HR, 1.542; P = .042), and distant metastasis-free survival (HR, 1.682; P = .024). In addition to the number of positive lymph nodes, the area under the receiver operating characteristic curve of the SIS for outcomes was higher than the neutrophil count-to-lymphocyte count ratio, platelet count-to-lymphocyte count ratio, and other conventional clinicopathologic indices. CONCLUSIONS: The preoperative SIS is a more sensitive survival predictor than most of the other conventional clinical indices and may aid in more accurately stratifying patients for risk assessment and treatment decision.
Authors: Qingpeng Zeng; Jiagen Li; Nan Sun; Qi Xue; Yushun Gao; Jun Zhao; Yousheng Mao; Juwei Mu; Dali Wang; Shugeng Gao; Jie He Journal: Transl Lung Cancer Res Date: 2021-01