Baseline platelet counts and derived inflammatory biomarkers: prognostic relevance in metastatic melanoma patients receiving Endostar plus dacarbazine and cisplatin

Figures & data

Table 1 Patients’ characteristics and details of univariate analysis (N=55)

Characteristics	No. of patients	% of total	Univariate P-value of progression free survival
Gender
Male	23	41.8	0.3879
Female	32	58.2
Age (years)
Median, Range	58	38～75
<60	34	61.8	0.1778
≥60	21	38.2
Baseline ECOG status
0	13	23.6	0.7442
1	30	54.6
2	12	21.8
AJCC stage
Unresectable III N3c	27	49.1	0.0102*
IV	28	50.9
M1a	6	10.9	0.1729
M1b	12	21.8
M1c	6	10.9
M1d	4	7.3
Melanoma subtype
Mucosal	12	21.8	0.0368*
Others	43	78.2
Acra	24	43.6
CSD	6	10.9
NCSD	13	23.7
Melanoma site
Head and neck	12	21.8	0.7227
Trunk	8	14.6
Limbs	35	63.6
Ulceration
Present	13	23.6	0.8873
Absent	42	76.4
Clark level
III or IV	22	40	0.4079
V	11	20
Breslow thickness (mm)
≤1.0	2	3.6	0.3956
1.01~2.0	5	9.1
2.01~4.0	15	27.3
>4.0	11	20
Biological Therapy
Yes	35	63.6	0.0102*
No	20	36.4
NLR
<1.37	8	14.5	0.4414
≥1.37	47	85.5
PLR
<206	46	83.6	0.0756
≥206	9	16.4
LMR
<4.83	36	65.5	0.1766
≥4.83	19	34.5
Platelet count (×10^9/L)
<168.5	18	32.7	0.0147*
≥168.5	37	67.3
PAR
<4.251	18	32.7	0.0018**
≥4.251	37	67.3
PGR
<4.694	11	20	0.0065**
≥4.694	44	80

Note: *P <0.05 and **P <0.01.

Abbreviations: No, number; ECOG, Eastern Cooperative Oncology Group; AJCC, American Joint Committee on Cancer; CSD, melanomas on skin with chronic sun-induced damage; NCSD, melanomas on skin without chronic sun-induced damage; NLR, neutrophil to lymphocyte ratio; PLR, platelet to lymphocyte ratio; LMR, lymphocyte to monocyte ratio; PAR, platelet to albumin ratio; PGR, platelet to globulin ratio.

Figure 1 Kaplan–Meier plot of PFS for all patients.

Table 2 Univariate and multivariate analysis for factors influencing progression free survival (PFS) of patients

Variables	Progression free survival (PFS)
	Univariate	Multivariate
P-value	HR (95%CI)	p-value
Biological Therapy (Yes vs No)	0.0102
AJCC stage (stage III vs stage IV)	0.0102	3.926 (1.578–9.766)	0.003
Melanoma subtype (Mucosal vs Others)	0.0368
Platelet count (<168.5 vs ≥168.5, ×10^9/L)	0.0147
PAR (<4.251 vs ≥4.251)	0.0018	0.656 (0.489–0.880)	0.005
PGR (<4.694 vs ≥4.694)	0.0065

Abbreviations: CI, confidence interval; AJCC, American Joint Committee on Cancer; PAR, platelet to albumin ratio; PGR, platelet to globulin ratio.

Figure 2 Subgroup analysis of progression-free survival by baseline clinical characteristics and inflammatory biomarkers, including (A) biological Therapy, (B) AJCC stage, (C) melanoma subtype, (D) platelet count, (E) platelet to albumin ratio，(F) platelet to globulin ratio.

Figure 3 ROC curve analysis of the potential inflammatory biomarkers in patients with metastatic melanoma.

Abbreviations: AUC, area under curve; CI, confidence interval; PAR, platelet to albumin ratio; PGR, platelet to globulin ratio.

Table 3 Adverse events experienced by the patients (N=55)

Adverse events	Grade				Total
	1 or 2		3 or 4
No.	%	No.	%	No.	%
Gastrointestinal
Loss of appetite	14	25.4	0	0	14	25.4
Nausea	18	32.7	0	0	18	32.7
Vomiting	14	25.4	1	1.8	15	27.2
Hepatic
Increase of aminotransferase	14	25.4	0	0	14	25.4
Increase of bilirubin	6	10.9	0	0	6	10.9
Hematologic
Leucopenia	13	23.6	1	1.8	14	25.4
Thrombocytopenia	14	25.4	1	1.8	15	27.2
Decrease of hemoglobin	12	21.8	0	0	12	21.8
Others
Increase of LDH	2	3.6	0	0	2	3.6
Increase of creatinase	1	1.8	0	0	1	1.8
Fever	20	36.4	0	0	20	36.4
Fatigue	5	9.1	0	0	5	9.1
Hypertension	2	3.6	0	0	2	3.6
Trichomadesis	4	7.3	0	0	4	7.3

Abbreviations: No, number; LDH, lactate dehydrogenase.