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Prognostic potential of neutrophil-to-lymphocyte ratio and lymphocyte nadir in stage III non-small-cell lung cancer

    Kylie H Kang

    School of Medicine, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH, USA

    ,
    Jimmy T Efird

    Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, University of Newcastle, 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia

    ,
    Neelesh Sharma

    University Hospitals Cleveland Medical Center, 11100 Euclid Ave., Cleveland, OH, USA

    ,
    Michael Yang

    University Hospitals Cleveland Medical Center, 11100 Euclid Ave., Cleveland, OH, USA

    ,
    Afshin Dowlati

    University Hospitals Cleveland Medical Center, 11100 Euclid Ave., Cleveland, OH, USA

    ,
    Philip Linden

    University Hospitals Cleveland Medical Center, 11100 Euclid Ave., Cleveland, OH, USA

    ,
    Mitchell Machtay

    Department of Radiation Oncology, University Hospitals Seidman Cancer Center, University Hospitals Cleveland Medical Center, 11100 Euclid Ave., Cleveland, OH, USA

    &
    Tithi Biswas

    *Author for correspondence:

    E-mail Address: Tithi.Biswas@UHhospitals.org

    Department of Radiation Oncology, University Hospitals Seidman Cancer Center, University Hospitals Cleveland Medical Center, 11100 Euclid Ave., Cleveland, OH, USA

    Published Online:https://doi.org/10.2217/fon-2017-0045

    Aim: Studies have shown increased pretreatment neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios to be predictive of survival in various cancers. Our aim was to evaluate the prognostic role of such inflammatory markers in non-small-cell lung cancer (NSCLC). Methods: One hundred and sixty-three patients with stage III NSCLC who received definitive treatment were included. Survival analysis was performed using Kaplan–Meier method. Hazard ratios for overall and recurrence-free survival were estimated using Cox proportional hazards model. Results: Both neutrophil-to-lymphocyte >Q75 (4.5) and lymphocyte nadir values <Q25 (0.25) and their unified values were associated with 90% increased overall mortality risk (p = 0.040) and a nonsignificant 50% decreased recurrence-free survival risk. Conclusion: Our exploratory analysis showed markers of systemic inflammation predicted survival outcomes in advanced NSCLC. Future prospective data analyses are needed to confirm this potential.

    Papers of special note have been highlighted as: • of interest; •• of considerable interest

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