The Prognostic Significance of Preoperative Platelet-to-Lymphocyte and Neutrophil-to-Lymphocyte Ratios in Patients Operated for Non-Small Cell Lung Cancer

Abstract

Introduction

The aim of the study was to determine the prognostic significance of PLR and NLR ratios in patients operated due to non-small cell lung cancer.

Material

The study group consisted of 532 (174 women, 358 men) patients with non-small cell lung cancer (NSCLC) staged IA-IIIA. The mean age was 63.6 years (range 36 to 84 years). Together with platelet/lymphocyte ratio (PLR) and neutrophil/lymphocyte ratio (NLR), the following factors were included in the statistical analysis: age, sex, smoking history, the number of leukocytes, neutrophils, and platelets, histopathology, T-stage, N-stage, concomitant diseases according to the Charlson Comorbidity Index (CCI), type of operation, adjuvant chemotherapy, and overall survival.

Results

Univariate analysis showed an association between the value of PLR and NLR and the length of survival. Multivariate analysis found that the stage of advancement of the neoplastic disease (p=0.00003), adjuvant chemotherapy (p=0.009), CCI > 4 (0.00008), and PLR > 144 (p=0.001) were negative prognostic factors for survival > 2 years; however, this effect diminishes in patients surviving more than 5 years.

Conclusion

PLR might serve as a prognostic factor in patients affected by NSCLC with expected two-year overall survival.

Keywords:

• carcinoma
• lymphocyte count
• neutrophil count
• non-small-cell
• platelet count
• ratio

Abbreviations

AUC, area under curve; CCI, Charlson Comorbidity Index; CPH, cox proportional hazard; CT, computed tomography; EBUS, endobronchial ultrasound; NLR, neutrophil-to-lymphocyte ratio; NSCLC, non-small cell lung cancer; OS, overall survival; PET-CT, positron-emission tomography with computed tomography; PLR, platelet-to-lymphocyte ratio; ROC, receiver operating characteristic; TNM, tumor node metastasis classification; UA, univariate analysis; UICC, union of international cancer control.

Disclosure

All authors declare no conflicts of interest.