Prognostic significance of preoperative peripheral blood neutrophil to lymphocyte ratio (NLR) in lung sarcomatoid carcinoma

BACKGROUND: The present study aimed to evaluate the prognostic value of the neutrophil to lymphocyte ratio (NLR) in patients with lung sarcomatoid carcinoma (LSC). METHODS: We retrospectively analyzed the clinicopathological parameters of 100 cases of LSC in the Sun Yat-sen University Cancer Center. Receiver operator characteristics curve analysis was performed to define the cutoff point for the preoperative peripheral blood NLR. The relationship between NLR and the clinicopathological parameters of patients with LSC was estimated using χ(2) analysis. Univariate and multivariate statistical analyses were carried out to evaluate the impact of preoperative blood NLR on postoperative survival of patients with LSC. RESULTS: The analyses revealed that the preoperative peripheral blood NLR was significantly associated with tumor size, pN stage, and clinical stage (P<0.05). No relationship was found between NLR and age, gender, smoking, pT stage, pM stage, relapse, and therapy. Preoperative peripheral blood NLR, clinical stage, pT stage, tumor-node-metastasis stage, and tumor size were associated with prognosis in the Kaplan-Meier survival analysis. Patients with a low NLR value had longer survival time than those with a high NLR [mean overall survival (OS) time: 87.1 vs. 16.0 months, P<0.05]. Cox multivariate analysis confirmed that preoperative peripheral blood NLR was an independent indicator for the prognosis of LSC (hazard ratio =3.906, P<0.05). CONCLUSIONS: The preoperative peripheral blood NLR was associated closely with the development and progression of LSC. Patients with an increased NLR were likely to have poor prognosis. Preoperative peripheral blood NLR might function as an important independent prognostic indicator for patients with LSC.