Pretreatment Neutrophil-to-lymphocyte Ratio As A Survival Predictor For Small-cell Lung Cancer

ObjectivesTo verify the prognostic value of NLR and PLR for OS in SCLC patients and to help us monitoring disease progression and adjusting treatments.MethodsWe retrospectively reviewed the records of 153 patients who were pathologically diagnosed with SCLC,and collected their hematological data at different time points during disease and treatment process.Kaplan-Meier analysis and Cox proportional hazards models were used to determine the prognostic significance of NLR and PLR for overall survival(OS)and progression-free survival(PFS).ResultsWe retrospectively analyzed 153 patients who were diagnosed with SCLC between January 2009 and September 2013 in Shandong Cancer Hospital and Institute.86 patients initially presented with limited stage and 67 with extensive disease.The median age of all patients was 62(range 28-79).The median OS and PFS for all patients were 23.3 months and 11.0 months.After applying cutoffs of 3.2 for NLR and 122.7 for PLR,NLR showed independent prognostic significance,but not PLR.High NLR group was associated with shorter median OS(high vs low,18.0 months vs 31.0 months,P < 0.01)and shorter PFS(high vs low,9.3 months vs 13.0 months,P = 0.006).The cumulative 3-year OS rate and 3-year PFS rate of high NLR group vs low NLR group were 14.3% vs 37.3% and 8.6% vs 22.9%,respectively.In multivariate analysis,both disease stage and NLR at diagnosis were independent prognostic factors for OS and PFS.ConclusionThe NLR at diagnosis showed significant prognostic value for clinical outcomes in SCLC patients treated with chemoradiotherapy(CRT).As an effective biomarker of host immune status,NLR could potentially help monitoring disease progression and adjusting treatment plans.