Evaluation of Predictive Values of Naples Prognostic Score in Patients with Unresectable Stage III Non-Small Cell Lung Cancer

Figures & data

Figure 1 The flow chart of case screening.

Table 1 Association of the Naples Prognostic Score and Clinical Characteristics

Characteristics		Naples Prognostic Score Group			P-value
	Values (N=206)	Group 0 (N=32)	Group 1 (N=135)	Group 2 (N=39)
Age (years)					0.002
<60	87	13	48	26
≥60	119	19	87	13
Gender					0.524
Male	120	21	75	24
Female	86	11	60	15
Smoke					0.302
No	111	15	78	18
Yes	95	17	57	21
KPS					0.219
90–100	92	17	62	13
70-80	114	15	73	26
Patient histology					0.458
SCC	90	11	60	19
AD	116	21	75	20
Differentiation					0.076
Well/Moderate	79	15	55	9
Poor	127	17	80	30
Tumor site					0.182
Left	96	16	67	13
Right	110	16	68	26
Primary tumor size					0.050
≤ 4cm	104	16	75	13
> 4cm	102	16	60	26
cTNM status					0.256
IIIA	81	16	53	12
IIIB	125	16	82	27
Serum CEA(ng/mL)					0.280
Normal	130	23	80	27
High	76	9	55	12
CYFRA21-1(ng/mL)					0.585
Normal	123	18	84	21
High	83	14	51	18
Treatment modality					0.960
CCRT	93	15	60	18
SCRT	113	17	75	21
Response rate					0.251
CR+PR	79	11	57	11
SD+PD	127	21	78	28

Abbreviations: KPS, Karnofsky performance score; SCC, squamous cell carcinoma; AD, adenocarcinoma; BM, brain metastases; CEA, carcinoembryonic antigen; CYFRA21-1, cytokeratin 19 fragments; CCRT, concurrent chemoradiotherapy; SCRT, Sequential chemoradiotherapy; CR, complete response; PR, partial response; SD, Stable disease; PD, progressive disease.

Table 2 The Result of NPS System Parameter

Parameters	Median (Range)
Serum albumin (mg/dL)	4.50(3.10–5.70)
Total cholesterol (mg/dL)	240(114.25–895.00)
Neutrophil	6.19(2.16–12.19)
Lymphocyte	1.72(0.45–4.85)
Monocyte	0.54 (0.14–4.90)
NLR	3.71(0.74–14.34)
LMR	2.97(0.99–11.70)

Abbreviations: NLR, neutrophil-to-lymphocyte ratio; LMR, lymphocyte-to-monocyte ratio.

Figure 2 The expression levels of serum albumin (A), total cholesterol (B), NLR (C) and LMR (D) in scatter diagrams.

Table 3 Univariate Cox Regression Analysis of OS and PFS

Characteristics	OS			PFS
	HR	95% CI	P-value	HR	95% CI	P-value
Age (years)			0.096			0.481
<60	1.000			1.0000
≥60	0.747	0.530–1.053		0.875	0.605–1.267
Gender			0.809			0.994
Male	1.000	0.744–1.462		1.000	0.692–1.441
Female	1.043			0.998
Smoke			0.099			0.071
No	1.000	0.535–1.055		1.000	0.497–1.029
Yes	0.751			0.715
KPS			0.001			0.005
90–100	1.000	1.245–2.512		1.000	1.184–2.530
70-80	1.768			1.731
Patient histology			0.894			0.553
SCC	1.000	0.730–1.433		1.000	0.774–1.613
AD	1.023			1.117
Differentiation			0.002			0.003
Well/Moderate	1.000	1.252–2.647		1.000	1.235–2.784
Poor	1.820			1.854
Tumor site			0.111			0.248
Left	1.000	0.939–1.848		1.000	0.861–1.785
Right	1.317			1.240
Primary tumor size			0.012			0.179
≤ 4 cm	1.000	1.102–2.183		1.000	0.893–1.841
> 4 cm	1.551			1.282
cTNM status			0.001			0.004
IIIA	1.000	1.291–2.654		1.000	1.209–2.640
IIIB	1.851			1.786
Serum CEA(ng/mL)			0.660			0.979
Normal	1.000	0.765–1.526		1.000	0.691–1.462
High	1.081			1.005
CYFRA21-1(ng/mL)			0.20			0.08
Normal	1.000	0.560–1.129	0	1.000	0.493–1.042	1
High	0.795			0.717
Treatment modality			0.11			0.13
CCRT	1.000	0.933–1.843	8	1.000	0.914–1.909	8
SCRT	1.311			1.321
Response rate			0.022			0.006
CR+PR	1.000	1.064–2.190		1.000	1.174–2.607
SD+PD	1.526			1.749
NPS Group			<0.001			<0.001
0,1	1.000	1.845–		1.000	1.600–
2	2.691	3.925		2.356	3.468

Abbreviations: OS, overall survival; PFS, progression-free survival; HR, hazard ratio; CI, confidence interval; KPS, Karnofsky performance score; SCC, squamous cell carcinoma; AD, adenocarcinoma; CEA, carcinoembryonic antigen; CYFRA21-1, cytokeratin 19 fragments; CCRT, concurrent chemoradiotherapy; SCRT, sequential chemoradiotherapy; CR, complete response; PR, partial response; SD, stable disease; PD, progressive disease.

Figure 3 Kaplan-Meier survival curves of overall survival for serum albumin (A), total cholesterol (B), NLR (C) and LMR (D).

Figure 4 Kaplan-Meier survival curves of progression-free survival for serum albumin (A), total cholesterol (B), NLR (C) and LMR (D).

Figure 5 Kaplan-Meier survival curves of overall survival (A) and progression-free survival (B) for NPS group.

Figure 6 Kaplan-Meier survival curves of overall survival (A) and progression-free survival (B) for NPS group in stage IIIA NSCLC, and overall survival (C) and progression-free survival (D) for NPS group in stage IIIB NSCLC.

Table 4 Multivariate Cox Regression Analysis of OS and PFS

Characteristics	OS			PFS
	HR	95% CI	P-value	HR	95% CI	P-value
KPS			0.436			0.710
90–100	1.000	0.668–2.548		1.000	0.5690–2.288
70-80	1.305			1.141
Differentiation			0.74			0.58
Well/Moderate	1.000	0.548–2.331	0	1.000	0.578–2.638	6
Poor	1.130			1.235
Primary tumor size			0.130
≤ 4cm	1.000	0.924–1.859
> 4cm	1.310
cTNM status			0.03			0.07
IIIA	1.000	1.038–2.204	1	1.000	0.958–2.181	9
IIIB	1.512			1.446
Response rate			0.189			0.092
CR+PR	1.000	0.885–1.856		1.000	0.944–2.155
SD+PD	1.282			1.426
NPS Group			0.001			0.006
0/1	1.000	1.326–2.981		1.000	1.182–2.721
2	1.988			1.793

Abbreviations: OS, overall survival; PFS, progression-free survival; HR, hazard ratio; CI, confidence interval; KPS, Karnofsky performance score; CR, complete response; PR, partial response; SD, stable disease; PD, progressive disease.