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Neutrophil-to-lymphocyte ratio can predict outcome in extensive-stage small cell lung cancer

Gordana Drpa
Gordana Drpa
, 
Maja Sutic
Maja Sutic
, 
Jurica Baranasic
Jurica Baranasic
, 
Marko Jakopovic
Marko Jakopovic
, 
Miroslav Samarzija
Miroslav Samarzija
, 
Suzana Kukulj
Suzana Kukulj
 oraz 
Jelena Knezevic
Jelena Knezevic
   | 22 wrz 2020
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Article Category: Research Article
Data publikacji: 22 wrz 2020
Zakres stron: 437 - 446
Otrzymano: 18 lut 2020
Przyjęty: 22 lip 2020
DOI: https://doi.org/10.2478/raon-2020-0054
© 2020 Gordana Drpa, Maja Sutic, Jurica Baranasic, Marko Jakopovic, Miroslav Samarzija, Suzana Kukulj, Jelena Knezevic, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

Probability of survival of all patients according to stage (p < 0.0001).
Probability of survival of all patients according to stage (p < 0.0001).

Figure 2

Probability of survival of extensive-stage disease small cell lung cancer patients according to neutrophil-to-lymphocyte ratio (NLR) cut-off 4 (p = 0.026) and NLR cut-off 5 (p = 0.036).
Probability of survival of extensive-stage disease small cell lung cancer patients according to neutrophil-to-lymphocyte ratio (NLR) cut-off 4 (p = 0.026) and NLR cut-off 5 (p = 0.036).

Patient characteristics regarding the disease stage

      VariableED-SCLC (n = 80)LD-SCLC (n = 60)p-values
      Age (years)            x̄ (SD)63.2 (9.1)63.0 (9.4)0.930
      Gender
           Male55 (68.8%)34 (56.7%)0.159
           Female25 (31.2%)26 (43.4%)
      Smoking
           Yes77 (96.2%)57 (95.0%)1.000
           No3 (3.8%)3 (5.0%)
      PS (ECOG)            0–164 (80.0%)52 (86.7%)0.368
           2–316 (20.0%)8 (13.3%)
      Chest irradiation
           Yes9 (11.2%)36 (60.0%)< 0.0001
           No71 (88.8%)24 (40.0%)
      PCI
           Yes2 (2.5%)10 (16.7%)0.004
           No78 (97.5%)50 (83.3%)
      Disease control
           Yes63 (78.8%)56 (93.3%)0.018
           No17 (21.2%)4 (6.7%)
      PFS (weeks)            x̄ (SD)30.1 (14.5)60.3 (57.9)< 0.0001
      OS (weeks)            x̄ (SD)48.3 (23.4)83.3 (59.3)< 0.0001
      Outcome
           dead79 (98.8%)46 (76.7%)0.013
           alive1 (1.2%)14 (23.3%)
      WBC count (x 109/l)            x̄ (SD)9.1 (3.7)9.2 (3.3)0.686
      Platelet count (x
      109/l)            x̄ (SD)293 (119)304 (95)0.249
      Hemoglobin (g/l)            x̄ (SD)130.9 (17.8)133.0 (16.8)0.540
      CRP (mg/l)            x̄ (SD)34.2 (44.6)21.2 (26.6)0.048
      Creatinine (umol/l)            x̄ (SD)81.9 (20.0)82.3 (29.6)0.443
      LDH (U/l)            x̄ (SD)336.2 (193.5)311.1 (607.3)0.004
      Lymphocytes (x
      109/l)            x̄ (SD)1.6 (0.8)1.7 (0.7)0.202
      Neutrophils (x 109/l)            x̄ (SD)6.6 (3.4)6.6 (3.2)0.812
      Monocytes (x109/l)            x̄ (SD)0.7 (0.3)0.7 (0.3)0.700
      NLR            x̄ (SD)5.1 (3.6)4.6 (3.4)0.485
      PLR            x̄ (SD)217.9 (119.9)213.4 (123.3)0.714
      LMR            x̄ (SD)2.5 (1.4)3.0 (2.4)0.271

Results of Cox regression analysis

VariableHR95.0% CI for HRp-value
ED-SCLCLowerUpper
Skin metastasesYes vs No0.0340.0060.1920.000
LDH< 241 vs. ≥ 2411.6911.1302.5300.011
Monocytes≤ 0.84 vs. > 0.841.0570.6751.6550.809
NLR< 4 vs. ≥ 41.4970.7572.9610.246
NLR< 5 vs. ≥ 50.7950.3911.6150.525
LD-SCLC
ECOG0–1 vs. 2–32.8651.0327.9530.043
Chest irradiationYes vs. No1.5580.7933.0470.195
PCIYes vs. No2.0380.8934.6540.091
HemoglobinNormal vs. Anemia1.4390.7732.6780.251
CreatinineNormal vs. Elevated1.4320.15513.1980.751

Prognostic parameters for survival – extensive-stage disease (ED)

VariableNo. of patientsMedian survival (weeks) - 95% CIp-values (log-rank test)
Skin metastasesYes No4 7615.9 (0.7–31.0) 46.9 (42.7–51.0)< 0.0001
LDH (U/l)< 241 ≥ 24126 3654.0 (45.4–62.6) 33.7 (22.8–44.6)0.017
NLR< 4 ≥ 440 4050.1 (43.5–56.8) 44.7 (37.4–52.0)0.026
NLR< 5 ≥ 550 3050.1 (44.7–55.6) 39.6 (30.7–48.5)0.036

Prognostic parameters for survival – all patients

VariableNo. of patientsMedian survival (weeks) - 95% CIp-values (log-rank test)
Extent of diseaseLD ED60 8064.1 (56.7–71.6) 45.7 (42.3–49.2)< 0.0001
Chest irradiationYes No45 9569.1 (63.3–75.0) 45.3 (39.0–51.6)< 0.0001
PCIYes No12 12869.0 (12.3–125.7) 49.1 (43.4–54.9)0.003
Disease controlYes No119 2153.4 (49.5–57.3) 36.4 (25.3–47.5)0.013
Hemoglobin (g/l)M ≥ 138 F ≥ 119 < 138 < 11978 6257.1 (50.6–63.6) 40.6 (28.9–52.3)0.006
CRP (mg/l)< 5.0 ≥ 5.035 10457.1 (48.9–65.4) 47.9 (41.4–54.3)0.026
LDH (U/l)< 241 ≥ 24155 5663.0 (53.0–73.0) 37.0 (27.7–46.3)0.002
Monocytes (x109/l)≤ 0.84 > 0.8499 4155.0 (49.5–60.5) 44.3 (33.2–55.4)0.048

Prognostic parameters for survival – limited-stage disease (LD)

VariableNo. of patientsMedian survival (weeks) - 95% CIp-values (log-rank test)
PS (ECOG)0–1 2–352 866.3 (57.6–75.0) 35.9 (8.3–63.4)0.007
Chest irradiationYes No36 2470.7 (51.8–89.6) 36.7 (16.1–57.3)0.003
PCIYes No10 50102.0 (0.0–209.6) 58.3 (46.7–69.8)0.032
Hemoglobin (g/l)M ≥ 138 F ≥ 119 < 138 < 11935 2571.9 (57.0–86.8) 54.3 (17.7–90.9)0.033
Creatinine (umol/l)M < 125 F < 107 ≥ 125 ≥ 10757 366.3 (58.6–74.0) 32.9 (27.8–37.9)0.001
eISSN:
1581-3207
Język:
Angielski
Częstotliwość wydawania:
4 razy w roku
Dziedziny czasopisma:
Medicine, Clinical Medicine, Internal Medicine, Haematology, Oncology, Radiology
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