The derived neutrophil/lymphocyte ratio predicts poor clinical outcome in soft tissue sarcoma patients

Joanna Szkandera, Armin Gerger, Bernadette Liegl-Atzwanger, Michael Stotz, Hellmut Samonigg, Joerg Friesenbichler, Tatjana Stojakovic, Andreas Leithner, Martin Pichler
American Journal of Surgery 2015, 210 (1): 111-6

BACKGROUND: Inflammation plays an important role in tumor proliferation and survival in cancer patients. The aim of this study was to investigate the prognostic impact of the pre-operative-derived neutrophil/lymphocyte ratio (dNLR) in a large cohort of soft tissue sarcoma (STS) patients after curative surgical resection.

METHODS: The impact of preoperative dNLR on disease-free survival (DFS) and overall survival (OS) in retrospectively evaluated 340 STS patients was assessed using Kaplan-Meier curves and Cox proportional models.

RESULTS: Applying receiver operating curve analysis, we determined a cut-off value of 2.39 for the dNLR to be optimal for discrimination of patients' survival in the whole cohort. Kaplan-Meier curves revealed a dNLR greater than or equal to 2.39 as a marker for decreased DFS (P = .031) and OS (P = .007, log-rank test) in STS patients. In multivariate analysis, increased dNLR was significantly associated with poor OS (hazard ratio 1.60, 95% confidence interval 1.07 to 2.40, P = .022).

CONCLUSIONS: This study demonstrates that preoperative dNLR might represent a well-correlated surrogate marker for the widely validated NLR. The dNLR is easily obtainable and can provide important information for individual risk assessment in clinical trials.

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