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Prognostic performance of inflammation-based prognostic indices in primary operable non-small cell lung cancer
BACKGROUND: At least 30% of patients with primary resectable non-small cell lung cancer (NSCLC) will experience a relapse in their disease within 5 years following definitive treatment. Clinicopathological predictors have proved to be suboptimal in identifying high-risk patients. We aimed to establi...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3992503/ https://www.ncbi.nlm.nih.gov/pubmed/24667648 http://dx.doi.org/10.1038/bjc.2014.145 |
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author | Pinato, D J Shiner, R J Seckl, M J Stebbing, J Sharma, R Mauri, F A |
author_facet | Pinato, D J Shiner, R J Seckl, M J Stebbing, J Sharma, R Mauri, F A |
author_sort | Pinato, D J |
collection | PubMed |
description | BACKGROUND: At least 30% of patients with primary resectable non-small cell lung cancer (NSCLC) will experience a relapse in their disease within 5 years following definitive treatment. Clinicopathological predictors have proved to be suboptimal in identifying high-risk patients. We aimed to establish whether inflammation-based scores offer an improved prognostic ability in terms of estimating overall (OS) and recurrence-free survival (RFS) in a cohort of operable, early-stage NSCLC patients. METHODS: Clinicopathological, demographic and treatment data were collected prospectively for 220 patients operated for primary NSCLC at the Hammersmith Hospital from 2004 to 2011. Pretreatment modified Glasgow Prognostic Score (mGPS), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were tested together with established prognostic factors in uni- and multivariate Cox regression analyses of OS and RFS. RESULTS: Half of the patients were male, with a median age of 65. A total of 57% were classified as stage I with adenocarcinoma being the most prevalent subtype (60%). Univariate analyses of survival revealed stage (P<0.001), grade (P=0.02), lymphovascular (LVI, P=0.001), visceral pleural invasion (VPI, P=0.003), mGPS (P=0.02) and NLR (P=0.04) as predictors of OS, with stage (P<0.001), VPI (P=0.02) and NLR (P=0.002) being confirmed as independent prognostic factors on multivariate analyses. Patients with more advanced stage (P<0.001) and LVI (P=0.008) had significantly shorter RFS. CONCLUSIONS: An elevated NLR identifies operable NSCLC patients with a poor prognostic outlook and an OS difference of almost 2 years compared to those with a normal score at diagnosis. Our study validates the clinical utility of the NLR in early-stage NSCLC. |
format | Online Article Text |
id | pubmed-3992503 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Nature Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-39925032015-04-15 Prognostic performance of inflammation-based prognostic indices in primary operable non-small cell lung cancer Pinato, D J Shiner, R J Seckl, M J Stebbing, J Sharma, R Mauri, F A Br J Cancer Clinical Study BACKGROUND: At least 30% of patients with primary resectable non-small cell lung cancer (NSCLC) will experience a relapse in their disease within 5 years following definitive treatment. Clinicopathological predictors have proved to be suboptimal in identifying high-risk patients. We aimed to establish whether inflammation-based scores offer an improved prognostic ability in terms of estimating overall (OS) and recurrence-free survival (RFS) in a cohort of operable, early-stage NSCLC patients. METHODS: Clinicopathological, demographic and treatment data were collected prospectively for 220 patients operated for primary NSCLC at the Hammersmith Hospital from 2004 to 2011. Pretreatment modified Glasgow Prognostic Score (mGPS), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were tested together with established prognostic factors in uni- and multivariate Cox regression analyses of OS and RFS. RESULTS: Half of the patients were male, with a median age of 65. A total of 57% were classified as stage I with adenocarcinoma being the most prevalent subtype (60%). Univariate analyses of survival revealed stage (P<0.001), grade (P=0.02), lymphovascular (LVI, P=0.001), visceral pleural invasion (VPI, P=0.003), mGPS (P=0.02) and NLR (P=0.04) as predictors of OS, with stage (P<0.001), VPI (P=0.02) and NLR (P=0.002) being confirmed as independent prognostic factors on multivariate analyses. Patients with more advanced stage (P<0.001) and LVI (P=0.008) had significantly shorter RFS. CONCLUSIONS: An elevated NLR identifies operable NSCLC patients with a poor prognostic outlook and an OS difference of almost 2 years compared to those with a normal score at diagnosis. Our study validates the clinical utility of the NLR in early-stage NSCLC. Nature Publishing Group 2014-04-15 2014-03-25 /pmc/articles/PMC3992503/ /pubmed/24667648 http://dx.doi.org/10.1038/bjc.2014.145 Text en Copyright © 2014 Cancer Research UK http://creativecommons.org/licenses/by-nc-sa/3.0/ From twelve months after its original publication, this work is licensed under the Creative Commons Attribution-NonCommercial-Share Alike 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/3.0/ |
spellingShingle | Clinical Study Pinato, D J Shiner, R J Seckl, M J Stebbing, J Sharma, R Mauri, F A Prognostic performance of inflammation-based prognostic indices in primary operable non-small cell lung cancer |
title | Prognostic performance of inflammation-based prognostic indices in primary operable non-small cell lung cancer |
title_full | Prognostic performance of inflammation-based prognostic indices in primary operable non-small cell lung cancer |
title_fullStr | Prognostic performance of inflammation-based prognostic indices in primary operable non-small cell lung cancer |
title_full_unstemmed | Prognostic performance of inflammation-based prognostic indices in primary operable non-small cell lung cancer |
title_short | Prognostic performance of inflammation-based prognostic indices in primary operable non-small cell lung cancer |
title_sort | prognostic performance of inflammation-based prognostic indices in primary operable non-small cell lung cancer |
topic | Clinical Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3992503/ https://www.ncbi.nlm.nih.gov/pubmed/24667648 http://dx.doi.org/10.1038/bjc.2014.145 |
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