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Zemskova O, Yu NY, Löser A, Leppert J, Rades D. Prognostic Role of Platelet-to-Lymphocyte and Neutrophil-to-Lymphocyte Ratios in Patients Irradiated for Glioblastoma Multiforme. CANCER DIAGNOSIS & PROGNOSIS 2024; 4:408-415. [PMID: 38962535 PMCID: PMC11215454 DOI: 10.21873/cdp.10340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 04/25/2024] [Indexed: 07/05/2024]
Abstract
Background/Aim Previous studies suggested pre-operative platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) to be predictive factors in patients with glioblastoma multiforme (GBM). This study investigated the prognostic role of PLR and NLR prior to or at the beginning of radiotherapy. Patients and Methods In 80 patients with GBM receiving conventionally fractionated radiotherapy plus concurrent temozolomide following resection or biopsy, 12 factors including PLR and NLR were retrospectively evaluated regarding progression-free survival (PFS) and overall survival (OS). Results On multivariable analyses, PLR ≤150, Karnofsky performance score (KPS) 90-100, and O6-methylguanine-DNA methyltransferase promoter methylation were significantly associated with improved PFS. Single lesion, KPS 90-100, and adjuvant chemotherapy were significantly associated with OS; PLR ≤150 showed a trend. NLR ≤3 showed a trend for associations with PFS and OS on univariable analyses. Conclusion PLR prior to or at the beginning of radiotherapy was associated with treatment outcomes in patients irradiated for GBM and should be considered in future clinical trials.
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Affiliation(s)
- Oksana Zemskova
- Department of Radiation Oncology, University of Lübeck, Lübeck, Germany
- Department of Radioneurosurgery, Romodanov Neurosurgery Institute, Kyiv, Ukraine
| | - Nathan Y Yu
- Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ, U.S.A
| | - Anastassia Löser
- Department of Radiation Oncology, University of Lübeck, Lübeck, Germany
| | - Jan Leppert
- Department of Neurosurgery, University of Lübeck, Lübeck, Germany
| | - Dirk Rades
- Department of Radiation Oncology, University of Lübeck, Lübeck, Germany
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2
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Hadadi A, Smith KER, Wan L, Brown JR, Russler G, Yantorni L, Caulfield S, Lafollette J, Moore M, Kucuk O, Carthon B, Nazha B, Liu Y, Bilen MA. Baseline basophil and basophil-to-lymphocyte status is associated with clinical outcomes in metastatic hormone sensitive prostate cancer. Urol Oncol 2022; 40:271.e9-271.e18. [DOI: 10.1016/j.urolonc.2022.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 02/17/2022] [Accepted: 03/25/2022] [Indexed: 10/18/2022]
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Rades D, Cacicedo J, Lomidze D, Al-Salool A, Segedin B, Groselj B, Schild SE. Prognostic Value of Preclinical Markers after Radiotherapy of Metastatic Spinal Cord Compression-An Additional Analysis of Patients from Two Prospective Trials. Cancers (Basel) 2022; 14:cancers14102547. [PMID: 35626151 PMCID: PMC9139528 DOI: 10.3390/cancers14102547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/18/2022] [Accepted: 05/20/2022] [Indexed: 02/04/2023] Open
Abstract
For optimal personalization of treatment for metastatic spinal cord compression (MSCC), the patient’s survival prognosis should be considered. Estimation of survival can be facilitated by prognostic factors. This study investigated the prognostic value of pre-treatment preclinical markers, namely hemoglobin, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lactate dehydrogenase (LDH), and c-reactive protein (CRP), in 190 patients from two prospective trials who had poor or intermediate survival prognoses and were irradiated for MSCC with motor deficits. In addition, clinical factors including radiation regimen, age, gender, tumor type, interval from tumor diagnosis to MSCC, number of affected vertebrae, visceral metastases, other bone metastases, time developing motor deficits, ambulatory status, sensory function, and sphincter function were evaluated. On univariate analyses, NLR (p = 0.033), LDH (p < 0.001), CRP (p < 0.001), tumor type (p < 0.001), pre-radiotherapy ambulatory status (p < 0.001), and sphincter function (p = 0.011) were significant. In the subsequent Cox regression analysis, LDH (p = 0.007), CRP (p = 0.047), tumor type (p = 0.003), and ambulatory status (p = 0.010) maintained significance. In addition to clinical factors, preclinical markers may help in estimating the survival of patients irradiated for MSCC. Additional prospective trials are warranted.
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Affiliation(s)
- Dirk Rades
- Department of Radiation Oncology, University of Lubeck, 23562 Lubeck, Germany;
- Correspondence: ; Tel.: +49-451-500-45400
| | - Jon Cacicedo
- Department of Radiation Oncology, Cruces University Hospital/Biocruces Health Research Institute, 48903 Barakaldo, Bizkaia, Spain;
| | - Darejan Lomidze
- Radiation Oncology Department, Tbilisi State Medical University and Ingorokva High Medical Technology University Clinic, Tbilisi 0177, Georgia;
| | - Ahmed Al-Salool
- Department of Radiation Oncology, University of Lubeck, 23562 Lubeck, Germany;
| | - Barbara Segedin
- Department of Radiotherapy, Institute of Oncology Ljubljana, University of Ljubljana, 1000 Ljubljana, Slovenia; (B.S.); (B.G.)
| | - Blaz Groselj
- Department of Radiotherapy, Institute of Oncology Ljubljana, University of Ljubljana, 1000 Ljubljana, Slovenia; (B.S.); (B.G.)
| | - Steven E. Schild
- Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ 85259, USA;
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Liang C, Xu Z, Shen X, Wu K. Correlation between Neutrophil-to-Lymphocyte Ratio and Pretreatment Magnetic Resonance Imaging and Their Predictive Significance in Cervical Carcinoma Patients Referred for Radiotherapy. JOURNAL OF ONCOLOGY 2022; 2022:3409487. [PMID: 35342402 PMCID: PMC8956400 DOI: 10.1155/2022/3409487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/29/2022] [Accepted: 02/15/2022] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The aim of this study was to determine the correlation between neutrophil-to-lymphocyte ratio (NLR) and various tumor parameters assessed by pretreatment magnetic resonance imaging (MRI) and to evaluate their prognostic significance for cervical carcinoma treated with radiotherapy (RT). METHODS The study enrolled 78 patients with biopsy-proven squamous cell carcinoma (SCC) of primary cervical cancer (clinically staged IB2 to IVA) who were treated in the Department of Clinical Oncology of the University of Hong Kong-Shenzhen Hospital between August 2015 and May 2019. A retrospective analysis of patients with SCC was performed. Firstly, we investigated the correlations between NLR and MRI parameters. Then, univariate and multivariate analyses were performed to identify the prognostic factors for overall survival (OS) and progression-free survival (PFS). Kaplan-Meier curves were constructed for OS and PFS. RESULTS Higher NLR showed significant association with larger tumor diameter and parametrial invasion assessed by pretreatment MRI. Univariate analysis indicated that uterine body invasion, parametrial invasion, and NLR were associated with prognosis of cervical cancer. Multivariable analyses demonstrated that parametrial invasion and NLR higher than the cutoff were independently associated with shorter OS and PFS, whereas uterine body invasion showed a significantly unfavorable influence on OS but showed no significant effect on PFS. Using the three risk factors of NLR above cutoff, parametrial invasion, and uterine body invasion, patients were divided into three subgroups. The three-year OS rates of patients with zero risk factors, one risk factor, and two or three of these factors were 96%, 91%, and 42%, respectively (P < 0.001), showing a downward trend. CONCLUSIONS Uterine body invasion, parametrial invasion, and NLR were significant prognostic factors for patients with cervical carcinoma treated with RT. These results may supplement FIGO staging to improve prognostic assessment of patients.
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Affiliation(s)
- Chunyu Liang
- Department of Medical Imaging, Radiology Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518000, China
| | - Zhiyuan Xu
- Department of Clinical Oncology, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518000, China
| | - Xinping Shen
- Department of Medical Imaging, Radiology Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518000, China
| | - Kusheng Wu
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China
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5
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Iwamoto G, Kawahara T, Yokomizo Y, Miyoshi Y, Yao M, Uemura H. The neutrophil-to-lymphocyte ratio at the prostate-specific antigen nadir predicts the time to castration-resistant prostate cancer. Asian J Urol 2021; 8:332-334. [PMID: 34401340 PMCID: PMC8356057 DOI: 10.1016/j.ajur.2020.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Indexed: 11/30/2022] Open
Affiliation(s)
- Genta Iwamoto
- Department of Urology and Renal Transportation, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Takashi Kawahara
- Department of Urology and Renal Transportation, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan.,Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Yumiko Yokomizo
- Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Yasuhide Miyoshi
- Department of Urology and Renal Transportation, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Masahiro Yao
- Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Hiroji Uemura
- Department of Urology and Renal Transportation, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
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Komune N, Sato K, Hongo T, Miyazaki M, Masuda S, Koike K, Uchi R, Tsuchihashi NA, Noda T, Kogo R, Wakasaki T, Yasumatsu R, Nakagawa T. Prognostic Significance of Systemic Inflammatory Response in Cases of Temporal Bone Squamous Cell Carcinoma. Laryngoscope 2021; 131:1782-1789. [PMID: 33538330 DOI: 10.1002/lary.29421] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/23/2020] [Accepted: 01/13/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE/HYPOTHESIS Squamous cell carcinoma (SCC) of the temporal bone is an extremely rare condition. This rarity has led to a delay in the establishment of a standard treatment protocol and adequate staging system. Identification of prognostic markers of this disease from a variety of fields is desirable in the establishment of treatment guidelines for temporal bone SCC. The aim of this study is to assess the prognostic role of inflammation-based prognostic scores in cases of temporal bone SCC. STUDY DESIGN Case reries with chart review. METHODS A total of 71 cases of primary malignancy eligible for curative treatment at a single tertiary medical institute were retrospectively analyzed. Univariate and multivariate regression analyzes were used to investigate the association between the inflammation-based scores and 5-year overall survival. RESULTS Univariate Cox regression analyzes showed that a high neutrophil-to-lymphocyte ratio, high platelet-to-lymphocyte ratio, low lymphocyte-to-monocyte ratio, a Glasgow prognostic score of 2, and the systemic inflammation score of 2 were significantly associated with a poor prognosis, as well as a classification of T4 stage, presence of cervical lymph node metastasis, high white blood cell counts, and high C-reactive protein levels. The multivariate analysis showed that a clinical stage of T4 and a systemic inflammation score of 2 were independent prognostic markers. CONCLUSIONS Inflammation-based prognostic markers are associated with the survival of patients with temporal bone SCC, as well as other head and neck SCCs. LEVEL OF EVIDENCE 4 Laryngoscope, 131:1782-1789, 2021.
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Affiliation(s)
- Noritaka Komune
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kuniaki Sato
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takahiro Hongo
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masaru Miyazaki
- Department of Otorhinolaryngology, Fukuoka University Hospital and School of Medicine, Fukuoka, Japan
| | - Shogo Masuda
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kensuke Koike
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ryutaro Uchi
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Nana Akagi Tsuchihashi
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Teppei Noda
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ryunosuke Kogo
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takahiro Wakasaki
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ryuji Yasumatsu
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takashi Nakagawa
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Zhou JW, Mao YH, Liu Y, Liang HT, Samtani CC, Fu YW, Ye YL, Xiao G, Qin ZK, Liu CD, Yang JK, Zhou QZ, Guo WB, Xue KY, Zhao SC, Chen MK. A novel robust nomogram based on peripheral monocyte counts for predicting lymph node metastasis of prostate cancer. Asian J Androl 2021; 23:409-414. [PMID: 33533737 PMCID: PMC8269827 DOI: 10.4103/aja.aja_89_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Accurate methods for identifying pelvic lymph node metastasis (LNM) of prostate cancer (PCa) prior to surgery are still lacking. We aimed to investigate the predictive value of peripheral monocyte count (PMC) for LNM of PCa in this study. Two hundred and ninety-eight patients from three centers were divided into a training set (n = 125) and a validation set (n = 173). In the training set, the independent predictors of LNM were analyzed using univariate and multivariate logistic regression analyses, and the optimal cutoff value was calculated by the receiver operating characteristic (ROC) curve. The sensitivity and specificity of the optimal cutoff were authenticated in the validation cohort. Finally, a nomogram based on the PMC was constructed for predicting LNM. Multivariate analyses of the training cohort demonstrated that clinical T stage, preoperative Gleason score, and PMC were independent risk factors for LNM. The subsequent ROC analysis showed that the optimal cutoff value of PMC for diagnosing LNM was 0.405 × 109 l-1 with a sensitivity of 60.0% and a specificity of 67.8%. In the validation set, the optimal cutoff value showed significantly higher sensitivity than that of conventional magnetic resonance imaging (MRI) (0.619 vs 0.238, P < 0.001). The nomogram involving PMC, free prostate-specific antigen (fPSA), clinical T stage, preoperative Gleason score, and monocyte-to-lymphocyte ratio (MLR) was generated, which showed a robust predictive capacity for predicting LNM before the operation. Our results indicated that PMC as a single agent, or combined with other clinical parameters, showed a robust predictive capacity for LNM in PCa. It can be employed as a complementary factor for the decision of whether to conduct pelvic lymph node dissection.
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Affiliation(s)
- Jia-Wei Zhou
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - Yun-Hua Mao
- Department of Urology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - Yang Liu
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - Hai-Tao Liang
- Department of Urology, Cancer Center of Sun Yat-sen University, Guangzhou 510060, China
| | - Chandni Chandur Samtani
- Department of International Medical Education, The Southern Medical University, Guangzhou 510515, China
| | - Yue-Wu Fu
- Department of Surgery, The First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Yun-Lin Ye
- Department of Urology, Cancer Center of Sun Yat-sen University, Guangzhou 510060, China
| | - Gang Xiao
- Department of Laboratory Medicine, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - Zi-Ke Qin
- Department of Urology, Cancer Center of Sun Yat-sen University, Guangzhou 510060, China
| | - Cun-Dong Liu
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - Jian-Kun Yang
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - Qi-Zhao Zhou
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - Wen-Bin Guo
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - Kang-Yi Xue
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - Shan-Chao Zhao
- Department of Urology, Nanfang Hospital of Southern Medical University, Guangzhou 510515, China
| | - Ming-Kun Chen
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
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8
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Sun S, Qu Y, Wen F, Yu H. Initial neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as prognostic markers in patients with inoperable locally advanced non-small-cell lung cancer. Biomark Med 2020; 14:1341-1352. [PMID: 32808809 DOI: 10.2217/bmm-2019-0583] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 07/27/2020] [Indexed: 02/06/2023] Open
Abstract
Aim: To determine whether pretreatment of neutrophil-to-lymphocyte ratio (NLR) or platelet-to-lymphocyte ratio (PLR) has a prognostic value in patients with inoperable locally advanced non-small-cell lung cancer. Materials & methods: A total of 167 patients between 2013 and 2016 were analyzed retrospectively. Results: Appropriate cut-off values for initial NLR (3.06) and PLR (168.03) were determined by receiver operating characteristic curves. High NLR (p < 0.001 and p < 0.001) was related to poor overall survival (OS) and progression-free survival (PFS) via univariate analysis. Multivariable analysis showed that NLR can independently influence OS (hazard ratio: 1.570; p = 0.012) and PFS (hazard ratio: 1.471; p = 0.023). PLR did not correlate with OS or PFS. Conclusion: Pretreatment of NLR could independently predict the prognosis of inoperable locally advanced non-small-cell lung cancer patients, while pretreatment of PLR does not have prognostic value.
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Affiliation(s)
- Siyu Sun
- Radiation Oncology Department of Thoracic Cancer, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, No. 44 Xiaoheyan Road, Dadong District Shenyang, Liaoning Province 110042, PR China
| | - Yanli Qu
- Radiation Oncology Department of Thoracic Cancer, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, No. 44 Xiaoheyan Road, Dadong District Shenyang, Liaoning Province 110042, PR China
| | - Fengyun Wen
- Radiation Oncology Department of Thoracic Cancer, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, No. 44 Xiaoheyan Road, Dadong District Shenyang, Liaoning Province 110042, PR China
| | - Hong Yu
- Radiation Oncology Department of Thoracic Cancer, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, No. 44 Xiaoheyan Road, Dadong District Shenyang, Liaoning Province 110042, PR China
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9
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Kawahara T, Kato M, Tabata K, Kojima I, Yamada H, Kamihira O, Tsumura H, Iwamura M, Uemura H, Miyoshi Y. A high neutrophil-to-lymphocyte ratio is a poor prognostic factor for castration-resistant prostate cancer patients who undergo abiraterone acetate or enzalutamide treatment. BMC Cancer 2020; 20:919. [PMID: 32977754 PMCID: PMC7519532 DOI: 10.1186/s12885-020-07410-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 09/14/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Inflammatory cytokine markers, including the neutrophil-to-lymphocyte ratio (NLR), monocyte-lymphocyte ratio, and platelet-to-lymphocyte ratio, play important roles as prognostic markers in several solid malignancies, including prostate cancer. We previously reported the NLR as a poor prognostic marker in bladder cancer, upper-urothelial carcinoma, adrenocortical carcinoma, penile cancer, and prostate cancer. This study examined the importance of the NLR as a prognostic marker for castration-resistant prostate cancer (CRPC) patients who received abiraterone acetate or enzalutamide. METHODS A total of 805 prostate cancer patients developed in CRPC status were enrolled in this study. Of these patients, 449 received abiraterone acetate (ABI; 188 cases) or enzalutamide (ENZ; 261 cases) treatment, and the pre-treatment NLR values of these patients were obtained. We investigated the prognosis in those with higher and lower NLR values. RESULTS The median NLR was 2.90, and a receiver operating characteristics analysis suggested a candidate cut-off point of 3.02. The median overall survival (OS) was 17.3 months in the higher NLR group (≥3.02) and 27.3 months in the lower NLR group (< 3.02) (p < 0.0001). This trend was also observed in both the ABI and ENZ groups (ABI: 29.3 vs. 15.1 months; ENZ: NR vs. 19.5 months; p < 0.0001 and < 0.0001, respectively). A multivariate analysis revealed that a higher NLR was an independent risk factor. The NLR value was thus shown to be correlated with the prostate cancer progression. CONCLUSIONS A higher NLR was associated with a poorer OS for CRPC patients who received ABI or ENZ. The NLR was positively correlated with prostate cancer progression.
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Affiliation(s)
- Takashi Kawahara
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, 2320024 Japan
| | - Masashi Kato
- Department of Urology, Nagoya University, Nagoya, 4668560 Japan
| | - Kenichi Tabata
- Department of Urology, Kitasato University School of Medicine, Sagamihara, 2520375 Japan
| | - Ippei Kojima
- Department of Urology, Nagoya University, Nagoya, 4668560 Japan
| | - Hiroshi Yamada
- Department of Urology, Nagoya University, Nagoya, 4668560 Japan
| | - Osamu Kamihira
- Department of Urology, Nagoya University, Nagoya, 4668560 Japan
| | - Hideyasu Tsumura
- Department of Urology, Kitasato University School of Medicine, Sagamihara, 2520375 Japan
| | - Masatsugu Iwamura
- Department of Urology, Kitasato University School of Medicine, Sagamihara, 2520375 Japan
| | - Hiroji Uemura
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, 2320024 Japan
| | - Yasuhide Miyoshi
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, 2320024 Japan
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Lee BM, Cho Y, Kim JW, Jeung HC, Lee IJ. Prognostic Significance of Sarcopenia in Advanced Biliary Tract Cancer Patients. Front Oncol 2020; 10:1581. [PMID: 32984018 PMCID: PMC7492547 DOI: 10.3389/fonc.2020.01581] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 07/22/2020] [Indexed: 01/03/2023] Open
Abstract
Background: Sarcopenia, systemic inflammation, and low muscularity significantly impact the survival of cancer patients. However, few studies have investigated how sarcopenia and systemic inflammation affect the prognosis of biliary tract cancer with distant metastasis. In this study, we investigated the association between sarcopenia with systemic inflammation and prognosis of metastatic biliary tract cancer. Materials and Methods: Data collected from 353 metastatic biliary tract cancer patients from 2007 to 2016 were analyzed. To evaluate the skeletal muscle mass, computed tomography images at the upper level of the third lumbar vertebra (L3) were used. Sarcopenia was defined using the Japan Society of Hepatology guideline; L3 muscle index <42 cm2/m2 for male and <38 cm2/m2 for female patients. Systemic inflammation was evaluated using the neutrophil lymphocyte ratio (NLR). Patients with NLR > 3 were categorized into the inflammatory category. The overall survival (OS) and progression free survival (PFS) were analyzed. Subgroup analysis was performed on those who received gemcitabine/cisplatin (GP) chemotherapy and depending on the presence of sarcopenia and inflammation. Results: Patients with sarcopenia showed lesser 1-year OS than those without (25.5 vs. 38.2%, p = 0.019). The patients with high NLR (NLR > 3) were associated with a shorter OS than were those with a low NLR (NLR ≤ 3) (21.0 vs. 52.8%, p < 0.001). Based on these results, we categorized the patients into three groups; sarcopenia accompanied by high NLR, no sarcopenia and low NLR, and either sarcopenia or high NLR. The OS of patients was well-stratified according to this grouping (1-year OS; 18.3 vs. 30.3 vs. 55.8%, p < 0.001). Concordant with OS results, the PFS was well-stratified based on the presence of either sarcopenia or high NLR (Sarcopenia; 9.5 vs. 19.4%, p < 0.001, NLR; 10.0 vs. 23.4%, p < 0.001). The PFS was significantly associated with high NLR and sarcopenia (1-year PFS; 7.8 vs. 13.0 vs. 27.9%, p < 0.001). Conclusion: Sarcopenia with inflammation was associated with inferior OS and PFS. In addition, sarcopenia accompanied by inflammation was associated with poor prognosis. Conservative treatments such as nutritional support, exercise, and pharmacologic intervention could help metastatic biliary tract cancer patients to overcome sarcopenia and the inflammatory status.
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Affiliation(s)
- Byung Min Lee
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Yeona Cho
- Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Jun Won Kim
- Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Hei Cheul Jeung
- Division of Medical Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Ik Jae Lee
- Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
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11
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Tang M, Li L, Zhang P, Wu X, Wang H. The Geriatric Nutritional Risk Index Predicts Overall Survival in Geriatric Patients with Metastatic Lung Adenocarcinoma. Nutr Cancer 2020; 73:1-9. [PMID: 32238011 DOI: 10.1080/01635581.2020.1743865] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 10/22/2019] [Accepted: 10/31/2019] [Indexed: 12/24/2022]
Abstract
The geriatric nutritional risk index (GNRI) is a simplified nutritional assessment. This study aimed to evaluate the prognostic value of the pretreatment GNRI in geriatric patients with metastatic lung adenocarcinoma (MLA). The clinicopathological characteristics of 144 geriatric patients with MLA were analyzed. The receiver operating characteristic curve was used to determine the best cutoff value of GNRI for predicting overall survival (OS). The Cox regression was used to identify variables associated with OS in the whole group, the non-sensitizing EGFR mutation subgroup, and the sensitizing EGFR mutation subgroup. The best cutoff value of the GNRI was 97 and the incidence of malnutrition risk was 52.1%. Low GNRI were significantly associated with older age (p = 0.002), a high ECOG score (p = 0.037), and a high neutrophil/lymphocyte ratio (p = 0.004). Low GNRI (p < 0.001), liver metastases (p < 0.001), and EGFR mutations (p < 0.001) were independent prognostic factors of OS. Low GNRI (p = 0.001), liver metastases (p < 0.001), and a high ECOG score (p = 0.003) were independent prognostic factors of OS in the non-sensitizing EGFR mutation subgroup, but not in the sensitizing EGFR mutation subgroup. This study shows the importance of the GNRI in predicting OS in geriatric patients with MLA, especially in patients without sensitizing EGFR mutations.
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Affiliation(s)
- Min Tang
- Medical Oncology, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Lin Li
- Medical Oncology, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Ping Zhang
- Medical Oncology, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Xiaonan Wu
- Medical Oncology, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Hui Wang
- Medical Oncology, Beijing Hospital, National Center of Gerontology, Beijing, China
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12
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Bravi CA, Rosiello G, Fallara G, Vertosick E, Tin A, Sjoberg D, Bianchi M, Mazzone E, Martini A, Dell'oglio P, Stabile A, Gandaglia G, Fossati N, Briganti A, Montorsi F, Vickers A. Predictive value of preoperative neutrophil-to-lymphocyte ratio in localized prostate cancer: results from a surgical series at a high-volume institution. Minerva Urol Nephrol 2020; 73:481-488. [PMID: 32083416 DOI: 10.23736/s2724-6051.20.03662-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND To examine the predictive value of neutrophil-to-lymphocyte ratio in localized prostate cancer for surgical pathology and recurrence in patients treated by radical prostatectomy. METHODS We evaluated 1258 patients treated by radical prostatectomy at San Raffaele Hospital between 2011 and 2017 and assessed the association between preoperative neutrophil-to-lymphocyte ratio and surgical pathology (advanced stage, grade group ≥4, nodal involvement, grade discordance between biopsy and surgical pathology) and biochemical recurrence. RESULTS The preoperative neutrophil-to-lymphocyte ratio was not significantly associated with advanced stage (≥T3), International Society of Urological Pathology (ISUP) grade (≥4) or discordance. At multivariable analysis, patients with higher neutrophil-to-lymphocyte ratio had lower risk of nodal involvement at final pathology (odds ratio [OR]: 0.77; 95% confidence interval [CI]: 0.64, 0.92; P=0.005). The preoperative level of neutrophil-to-lymphocyte ratio was associated with biochemical recurrence on univariate analysis (OR: 0.81, 95% CI: 0.68, 0.96; P=0.017). Such a relationship was not significant at multivariable analysis adjusting for tumor severity (OR: 0.93, 95% CI: 0.79, 1.09; P=0.4). CONCLUSIONS Neutrophil-to-lymphocyte ratio does not have clinical utility for the prediction of adverse pathology and biochemical recurrence. Further research should focus on its value for predicting regional lymph node metastasis.
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Affiliation(s)
- Carlo A Bravi
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy - .,Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA -
| | - Giuseppe Rosiello
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Giuseppe Fallara
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Emily Vertosick
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Amy Tin
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Daniel Sjoberg
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Marco Bianchi
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Elio Mazzone
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Alberto Martini
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Paolo Dell'oglio
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Armando Stabile
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Giorgio Gandaglia
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Nicola Fossati
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Alberto Briganti
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Francesco Montorsi
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Andrew Vickers
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Pan XB, Huang ST, Zhu XD. Neutrophil-to-lymphocyte ratio predicts the prognosis of stage II nasopharyngeal carcinoma. Cancer Manag Res 2019; 11:8269-8275. [PMID: 31571984 PMCID: PMC6749985 DOI: 10.2147/cmar.s213264] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 08/29/2019] [Indexed: 01/27/2023] Open
Abstract
Purpose To assess the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) in stage II nasopharyngeal carcinoma (NPC). Methods Stage II (2010 UICC/AJCC staging system) NPC patients treated between January 2007 and December 2014 were retrospectively analyzed. The NLR was calculated from peripheral blood cell counts before treatment. The optimal cut-off value of NLR was determined by receiver operating characteristic curve analysis. Survival rates were compared according to the NLR value. Multivariable Cox regression analyses were performed to assess the association between the NLR and overall survival (OS), locoregional-free survival (LRFS), and distant metastasis-free survival (DMFS). Results Two hundred and fifty-one stage II NPC patients were included in this study. The NLR was correlated with T stage (r=0.158, p=0.012). An NLR ≥2.92 was associated with poor 5-year OS (84.3% vs 97.4%, p=0.001) and LRFS (91.4% vs 98.4%, p=0.003). An NLR ≥2.82 was associated with poor 5-year DMFS (92.6% vs 98.2%, p=0.033). The multivariate Cox regression analysis showed that an NLR ≥2.92 was an independent prognostic biomarker in stage II NPC. Conclusion The NLR is an independent prognostic factor in stage II NPC.
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Affiliation(s)
- Xin-Bin Pan
- Department of Radiation Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi 530021, People's Republic of China
| | - Shi-Ting Huang
- Department of Radiation Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi 530021, People's Republic of China
| | - Xiao-Dong Zhu
- Department of Radiation Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi 530021, People's Republic of China
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Li Y, Wang B, Zhou S, Jiang L, Yang S, Liu X, Wei F, Zhang H, Wang Y, Liu Z. Do routine blood test results help in the diagnosis of spine tumors? A retrospective study of the significance of pretreatment neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios from 503 spine tumor patients. Medicine (Baltimore) 2019; 98:e14902. [PMID: 30985640 PMCID: PMC6485862 DOI: 10.1097/md.0000000000014902] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) are not fully evaluated for the diagnosis of musculoskeletal tumors, especially spine tumors. The objective of our study was to assess the feasibility of NLR and PLR as indicators for pretreatment diagnosis of spine tumors.Patients who underwent surgical treatment in our hospital for spine tumors were retrospectively analyzed. Blood test results (neutrophil, lymphocyte, and platelet counts) and final pathological results from surgery or biopsy specimen were collected. Spine tumors were divided into 4 groups. Diagnostic values of NLR and PLR were analyzed using the area under the receiver operating characteristic (ROC) curve (AUC).There were 503 patients included. The average age of all patients was 46.3 years. Age, NLR, and PLR were significantly different between benign and malignant tumors groups (P < .05), and ROC analysis showed that the AUC was 0.704 and 0.637 for NLR and PLR. Age, location, NLR, and PLR were significantly different between primary and nonprimary tumor groups (P < .05), and ROC analysis showed that the AUC was 0.713 and 0.647 for NLR and PLR. Age, location, NLR, and PLR were significantly different between primary benign and primary malignant tumor groups (P < .05), and ROC analysis showed that the AUC was 0.624 and 0.577 for NLR and PLR.Pretreatment NLR and PLR had clinical significance in the identification and pretreatment diagnosis of spine tumors. Additionally, NLR and PLR were significantly different between benign and malignant tumors, primary and nonprimary tumors, and primary benign and primary malignant tumors.
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Affiliation(s)
- Yan Li
- Orthopaedic Department, Peking University Third Hospital
| | - Ben Wang
- Orthopaedic Department, Peking University Third Hospital
- Peking University Health Science Center
| | - Siyu Zhou
- Orthopaedic Department, Peking University Third Hospital
- Peking University Health Science Center
| | - Liang Jiang
- Orthopaedic Department, Peking University Third Hospital
| | - Shaomin Yang
- Department of Pathology, Peking University Health Center
| | - Xiaoguang Liu
- Orthopaedic Department, Peking University Third Hospital
| | - Feng Wei
- Orthopaedic Department, Peking University Third Hospital
| | - Hua Zhang
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Haidian District, Beijing
| | - Yiyuan Wang
- Xi’an Jiaotong University Health Science Center, Yanta District, Xi’an, China
| | - Zhongjun Liu
- Orthopaedic Department, Peking University Third Hospital
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15
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Loubersac T, Nguile-Makao M, Pouliot F, Fradet V, Toren P. Neutrophil-to-lymphocyte Ratio as a Predictive Marker of Response to Abiraterone Acetate: A Retrospective Analysis of the COU302 Study. Eur Urol Oncol 2019; 3:298-305. [PMID: 31411963 DOI: 10.1016/j.euo.2019.01.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 11/27/2018] [Accepted: 01/08/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND The neutrophil-lymphocyte ratio (NLR) is an inexpensive and accessible prognostic marker for many cancers, including metastatic castration-resistant prostate cancer (mCRPC). OBJECTIVE In this study, we assess the role of NLR as a predictive biomarker through a retrospective analysis of the pivotal COU302 study of abiraterone acetate (AA) as first-line therapy for men with asymptomatic or minimally symptomatic mCRPC. DESIGN, SETTING, AND PARTICIPANTS The COU302 study randomized asymptomatic or minimally symptomatic men with mCRPC to receive AA plus prednisone or prednisone as first-line treatment. Baseline NLR, overall survival, radiographic progression-free survival, and prostate-specific antigen (PSA) progression-free survival were evaluated. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Descriptive statistics, as well as Kaplan-Meier and Cox survival models were used to assess the effect of baseline NLR and changes in NLR on response to AA plus prednisone versus prednisone, with adjustment for important covariates. RESULTS AND LIMITATIONS Among the 1082 patients who received treatment, baseline NLR values showed no significant differences according to baseline covariates except for albumin. Baseline variables were similar between dichotomous groups with an NLR cutoff of 2.5, except for a lower proportion of patients with >10 bone metastases in the NLR <2.5 group. Our survival results demonstrate that higher NLR values corresponded to poorer overall survival and PSA response to AA but not to placebo, which was confirmed in our adjusted regression models. No significant differences were seen in time to radiographic progression. In separate analyses, an increase or decrease in NLR by 2 from treatment baseline did not clearly signal subsequent lack of benefit with continued AA. CONCLUSIONS Our results suggest that baseline NLR may be able to predict response to AA in men with asymptomatic mCRPC but that changes in NLR during treatment are insufficient to guide treatment. Further validation studies are warranted. PATIENT SUMMARY In this report, we look at the ratio of circulating immune cells as a predictor of response to abiraterone acetate (AA), using data from a large trial. Our results suggest that this ratio derived from routinely obtained bloodwork can predict which patients respond better to AA.
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Affiliation(s)
| | - Molière Nguile-Makao
- Oncology Division, Department of Surgery, Faculty of Medicine, Centre Hospitalier Universitaire (CHU) de Québec Research Centre, Université Laval, Québec, QC, Canada
| | - Frédéric Pouliot
- Oncology Division, Department of Surgery, Faculty of Medicine, Centre Hospitalier Universitaire (CHU) de Québec Research Centre, Université Laval, Québec, QC, Canada
| | - Vincent Fradet
- Oncology Division, Department of Surgery, Faculty of Medicine, Centre Hospitalier Universitaire (CHU) de Québec Research Centre, Université Laval, Québec, QC, Canada
| | - Paul Toren
- Oncology Division, Department of Surgery, Faculty of Medicine, Centre Hospitalier Universitaire (CHU) de Québec Research Centre, Université Laval, Québec, QC, Canada.
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16
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Pretreatment Neutrophil to Lymphocyte Ratio (NLR) Predicts Prognosis for Castration Resistant Prostate Cancer Patients Underwent Enzalutamide. BIOMED RESEARCH INTERNATIONAL 2019; 2019:9450838. [PMID: 30800682 PMCID: PMC6360569 DOI: 10.1155/2019/9450838] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 11/26/2018] [Accepted: 12/11/2018] [Indexed: 12/29/2022]
Abstract
Introduction Nearly 80% of advanced prostate cancer patients respond to initial androgen deprivation therapy (ADT). However, ADT does not prevent the progression of prostate cancer over the long term, and the disease eventually progresses to castration-resistant prostate cancer (CRPC). Prior to the development of enzalutamide (ENZ) and abiraterone acetate, docetaxel was the only established treatment with life-prolongation for CRPC. ENZ is a second-generation anti-androgen receptor drug that has contributed to improving the prognosis of CRPC. Several studies have reported factors predicting the efficacy of ENZ; however, there are no confirmed biomarkers. The neutrophil-to-lymphocyte ratio (NLR) is an easily calculated biomarker that is associated with the prognosis of several solid malignancies. However, there were few studies investigated NLR for ENZ in patients with mCRPC. We examined the usefulness of the NLR as a predictive tool for ENZ. Methods We retrospectively examined a total of 106 CRPC patients who were treated with ENZ until September 2016 in Yokohama City University Hospital, Yokohama City University Medical Center, and National Cancer Center Hospital East. ENZ was routinely started as a dose of 160 mg per day; the dosage was reduced in some patients due to side effects. Drug holiday for 1-2 weeks or dose reduction to 80-120mg was done and no patients discontinued ENZ treatment due to adverse effects. ENZ was stopped when cancer progression was detected based on PSA elevation, radiographic findings, and deterioration of the patient's performance status. The cut-off NLRs for overall survival (OS) and cancer-specific survival (CSS) were determined based on the receiver-operator curves. Kaplan-Meier curves were used to analyze the factors associated with OS or CSS and a log-rank test was performed. A multivariate analysis was also performed to analyze the factors associated with the prognosis. Results We retrospectively reviewed 106 consecutive CRPC patients who were both treated with ENZ and were able to be counted before ENZ NLR. Cut-off point was 2.14 for both OS and CSS by receiver operator characteristic curve. The patients were then divided into the higher NLR group (≥2.14) and lower NLR group (<2.14). Multivariate analysis showed that NLR and predocetaxel chemotherapy were independent risk factors for both overall and cancer-specific survival. Conclusions The NLR might be a useful biomarker for predicting the prognosis of mCRPC patients who are treated with ENZ.
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McDermott SM, Saunders ND, Schneider EB, Strosberg D, Onesti J, Dillhoff M, Schmidt CR, Shirley LA. Neutrophil Lymphocyte Ratio and Transarterial Chemoembolization in Neuroendocrine Tumor Metastases. J Surg Res 2018; 232:369-375. [PMID: 30463743 DOI: 10.1016/j.jss.2018.06.058] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 06/11/2018] [Accepted: 06/19/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND The neutrophil-to-lymphocyte ratio (NLR) has been shown to be predictive of outcomes in various cancers, including neuroendocrine tumors (NETs), and cancer-related treatments, including transarterial chemoembolization (TACE). We hypothesized that NLR could be predictive of response to TACE in patients with metastatic NET. METHODS We reviewed 262 patients who underwent TACE for metastatic NET at a single tertiary medical center from 2000 to 2016. NLR was calculated from blood work drawn 1 d before TACE, as well as 1 d, 1 wk, and 6 mo after treatment. RESULTS The median post-TACE overall survival (OS) of the entire cohort was 30.1 mo. Median OS of patients with a pre-TACE NLR ≤ 4 was 33.3 mo versus 21.1 mo for patients with a pre-TACE NLR >4 (P = 0.005). At 6 mo, the median OS for patients with post-TACE NLR > pre-TACE NLR was 21.4 mo versus 25.8 mo for patients with post-TACE NLR ≤ pre-TACE NLR (P = 0.007). On multivariate analysis, both pre-TACE NLR and 6-mo post-TACE NLR were independent predictors of survival. NLR values from 1-d and 1-wk post-TACE did not correlate with outcome. CONCLUSIONS An elevated NLR pre-TACE and an NLR that has not returned to its pre-TACE value several months after TACE correlate with outcomes in patients with NET and liver metastases. This value can easily be calculated from laboratory results routinely obtained as part of preprocedural and postprocedural care, potential treatment strategies.
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Affiliation(s)
| | - Neil D Saunders
- Emory University School of Medicine, Division of General and GI Surgery, Atlanta, Georgia
| | - Eric B Schneider
- University of Virginia Department of Surgery, Charlottesville, Virginia
| | - David Strosberg
- The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Jill Onesti
- Mercy Health, Department of Surgery, Grand Rapids, Michigan
| | - Mary Dillhoff
- The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Carl R Schmidt
- The Ohio State University Wexner Medical Center, Columbus, Ohio
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Hashimoto M, Matsumura N, Ohzeki T, Hongo S, Sugimoto K, Shimizu N, Mori Y, Minami T, Nozawa M, Nose K, Tahara H, Yoshimura K, Uemura H. The Change in Neutrophil Lymphocyte Ratio from the First to the Last Repeat Prostate Biopsy Proposed as a Marker of Carcinogenesis. Urol Int 2018; 101:74-79. [PMID: 29909414 DOI: 10.1159/000489400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 04/18/2018] [Indexed: 12/28/2022]
Abstract
INTRODUCTION We investigated whether the change in the neutrophil lymphocyte ratio (NLR) from the first to the last repeat prostate biopsy (ΔNLR) could be the diagnostic tool or not for prostate cancer (PCa) detection. MATERIALS AND METHODS We retrospectively evaluated medical records of men who had undergone repeat prostate biopsy. The investigated parameters were white blood cell, neutrophil, lymphocyte counts, NLR at the last prostate biopsy, ΔNLR, prostate-specific antigen (PSA), PSA density (PSAD), and PSA velocity. Exclusion criteria were the presence of cancers other than prostate origin, medication, and diseases which induce the change of NLR. RESULTS A total of 301 men who had undergone repeat prostate biopsy were selected for this study. After applying exclusion criteria, 223 patients were included. Of these patients, 94 were diagnosed with PCa (Group I) and 129 with no malignancy (Group II). Only a single patient had metastasis. On evaluating the area under the receiver operating characteristic curve of all study parameters, ΔNLR was the most accurate marker, followed by PSAD and then NLR measured at the last biopsy. CONCLUSIONS ΔNLR was the most accurate marker to improve the total predictive value in repeat prostate biopsy for diagnosing PCa.
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Affiliation(s)
- Mamoru Hashimoto
- Department of Urology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Naoki Matsumura
- Department of Urology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Takayuki Ohzeki
- Department of Urology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Sachiko Hongo
- Department of Urology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Koichi Sugimoto
- Department of Urology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Nobutaka Shimizu
- Department of Urology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Yasunori Mori
- Department of Urology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Takafumi Minami
- Department of Urology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Masahiro Nozawa
- Department of Urology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Kazuhiro Nose
- Department of Urology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Hideo Tahara
- Department of Urology, Mimihara General Hospital, Sakai, Japan
| | - Kazuhiro Yoshimura
- Department of Urology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Hirotsugu Uemura
- Department of Urology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
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Murata H, Koyama K, Takezawa Y, Nishigaki Y. Baseline neutrophil-to-lymphocyte ratio predicts the prognosis of castration-resistant prostate cancer treated with abiraterone acetate. Mol Clin Oncol 2018; 8:592-594. [PMID: 29541468 DOI: 10.3892/mco.2018.1562] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 12/28/2017] [Indexed: 02/03/2023] Open
Abstract
Abiraterone acetate (AA), a CYP17 inhibitor, now has a crucial role in the treatment of castration-resistant prostate cancer (CRPC), and previous studies have reported several prognostic clinical factors for AA treatment. The neutrophil-to-lymphocyte ratio (NLR) has also been investigated for a CRPC treatments in a few reports, however it has not been identified to be a prognostic factor for AA treatment in Japanese patients. The present study aimed to assess the association of the baseline NLR with the overall survival (OS) in CPRC patients treated by AA. The present study retrospectively reviewed a total of 90 consecutive patients with CRPC treated with AA from 2011 to 2016 at Yokohama City University Medical Center and National Cancer Center Hospital East. The primary endpoint of the study was the OS, which was defined as the survival from the start of AA administration. The secondary endpoint was the prostate-specific antigen (PSA) response. PSA response was defined as a reduction in antigen levels of >50%. Complete blood cell counts were performed, and the NLR was calculated using the neutrophil and lymphocyte counts obtained on the same day or a few days prior to the initiation of AA therapy. The NLR cut-off point was determined to be 3.76 for the OS, and divided into the high NLR group of 34 patients and the low NLR group of 56 patients. A PSA response was obtained in 8 patients (23.5%) in the high NLR group and in 24 (42.9%) in the low NLR group. The difference of PSA response between the two groups was significant (P=0.037). Kaplan-Meier curves demonstrated that a high NLR [NLR ≥3.76; median OS: 8.4 months; 95% confidence interval (CI): 6.325-10.475 months] was correlated with a risk of mortality compared with a low NLR (NLR <3.76; median OS not reached). A multivariate analysis demonstrated that the NLR was an independent predictor for the OS (hazard ratio: 2.682; 95% CI: 1.143-6.293; P=0.023). The findings suggest that the NLR may be a useful novel biomarker for predicting the prognosis of CRPC patients treated with AA.
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Affiliation(s)
- Hiroaki Murata
- Department Orthopaedics, Matsushita Memorial Hospital, Moriguchi, Osaka 570-8540, Japan
| | - Kenzou Koyama
- Department Orthopaedics, Matsushita Memorial Hospital, Moriguchi, Osaka 570-8540, Japan
| | - Yasunobu Takezawa
- Department Orthopaedics, Matsushita Memorial Hospital, Moriguchi, Osaka 570-8540, Japan
| | - Yasunori Nishigaki
- Department Orthopaedics, Matsushita Memorial Hospital, Moriguchi, Osaka 570-8540, Japan
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Neutrophil-to-Lymphocyte Ratio Predicts Prognosis in Castration-Resistant Prostate Cancer Patients Who Received Cabazitaxel Chemotherapy. BIOMED RESEARCH INTERNATIONAL 2017; 2017:7538647. [PMID: 28948170 PMCID: PMC5602619 DOI: 10.1155/2017/7538647] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 07/30/2017] [Indexed: 12/11/2022]
Abstract
INTRODUCTION AND OBJECTIVES An elevated neutrophil-to-lymphocyte ratio (NLR) has been suggested to be associated with a poor prognosis in several cancers. We evaluated the utility of an elevated NLR as a biomarker to predict the prognosis of metastatic castration-resistant prostate cancer (mCRPC) patients treated with cabazitaxel (CBZ). METHODS We analyzed 47 patients who received CBZ chemotherapy for mCRPC in our institutions. The NLR was calculated using the neutrophil and lymphocyte counts before CBZ chemotherapy. We determined the NLR cut-off value based on the sensitivity and specificity levels derived from area under the receiver operator characteristic curves for death. A multivariate analysis was performed to investigate the association between the NLR and the prognosis. RESULTS The median overall survival (OS) after CBZ was 10.0 months (range: 6.3-13.2). The median OS was shorter in patients with a high NLR (≥3.83) than in those with a low NLR (<3.83) (5.8 versus 13.2 months, p = 0.018). In the multivariate analysis, the NLR, patient age, and lymph node (LN) metastasis were independent predictors of the OS (hazard ratio 3.01, p = 0.030; hazard ratio 3.10, p = 0.029; hazard ratio 12.38, p = 0.001, resp.). CONCLUSIONS NLR might be a useful prognostic biomarker in mCRPC patients treated with CBZ.
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Ikeguchi M, Hanaki T, Endo K, Suzuki K, Nakamura S, Sawata T, Shimizu T. C-Reactive Protein/Albumin Ratio and Prognostic Nutritional Index Are Strong Prognostic Indicators of Survival in Resected Pancreatic Ductal Adenocarcinoma. J Pancreat Cancer 2017. [DOI: 10.1089/crpc.2017.0006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Masahide Ikeguchi
- Department of Surgery, Tottori Prefectural Central Hospital, Tottori, Japan
| | - Takehiko Hanaki
- Department of Surgery, Tottori Prefectural Central Hospital, Tottori, Japan
| | - Kanenori Endo
- Department of Surgery, Tottori Prefectural Central Hospital, Tottori, Japan
| | - Kazunori Suzuki
- Department of Surgery, Tottori Prefectural Central Hospital, Tottori, Japan
| | - Seiichi Nakamura
- Department of Surgery, Tottori Prefectural Central Hospital, Tottori, Japan
| | - Takashi Sawata
- Department of Surgery, Tottori Prefectural Central Hospital, Tottori, Japan
| | - Tetsu Shimizu
- Department of Surgery, Tottori Prefectural Central Hospital, Tottori, Japan
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22
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Treffers LW, Hiemstra IH, Kuijpers TW, van den Berg TK, Matlung HL. Neutrophils in cancer. Immunol Rev 2017; 273:312-28. [PMID: 27558343 DOI: 10.1111/imr.12444] [Citation(s) in RCA: 137] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Neutrophils play an important role in cancer. This does not only relate to the well-established prognostic value of the presence of neutrophils, either in the blood or in tumor tissue, in the context of cancer progression or for the monitoring of therapy, but also to their active role in the progression of cancer. In the current review, we describe what is known in general about the role of neutrophils in cancer. What is emerging is a complex, rather heterogeneous picture with both pro- and anti-tumorigenic roles, which apparently differs with cancer type and disease stage. Furthermore, we will discuss the well-known role of neutrophils as myeloid-derived suppressor cells (MDSC), and also on the role of neutrophils as important effector cells during antibody therapy in cancer. It is clear that neutrophils contribute substantially to cancer progression in multiple ways, and this includes both direct effects on the cancer cells and indirect effect on the tumor microenvironment. While in many cases neutrophils have been shown to promote tumor progression, for instance by acting as MDSC, there are also protective effects, particularly when antibody immunotherapy is performed. A better understanding of the role of neutrophils is likely to provide opportunities for immunomodulation and for improving the treatment of cancer patients.
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Affiliation(s)
- Louise W Treffers
- Sanquin Research, and Landsteiner Laboratory, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Ida H Hiemstra
- Sanquin Research, and Landsteiner Laboratory, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Taco W Kuijpers
- Sanquin Research, and Landsteiner Laboratory, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Timo K van den Berg
- Sanquin Research, and Landsteiner Laboratory, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Hanke L Matlung
- Sanquin Research, and Landsteiner Laboratory, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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23
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Terada N, Akamatsu S, Kobayashi T, Inoue T, Ogawa O, Antonarakis ES. Prognostic and predictive biomarkers in prostate cancer: latest evidence and clinical implications. Ther Adv Med Oncol 2017; 9:565-573. [PMID: 28794807 PMCID: PMC5524249 DOI: 10.1177/1758834017719215] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 06/13/2017] [Indexed: 01/05/2023] Open
Abstract
Advances in our understanding of the mechanisms driving castration-resistant prostate cancer have promoted the development of several new drugs including androgen receptor-directed therapy and chemotherapy. Concomitant docetaxel treatment at the beginning of hormonal therapy for metastatic prostate cancer has resulted in longer overall survival than with hormonal therapy alone. Elucidating an appropriate treatment sequence using these therapies is important for maximizing clinical benefit in castration-sensitive and castration-resistant prostate cancer patients. The development of advanced high-throughput ‘omics’ technology has enabled the use of novel markers to guide prognosis and treatment of this disease. In this review, we outline the genomic landscape of prostate cancer and the molecular mechanisms of castration-resistant progression, and how these affect the development of new drugs, and their clinical implications for selecting treatment sequence. We also discuss many of the potential tissue-based or liquid biomarkers that may soon enter clinical use, with the hope that several of these prognostic or predictive markers will guide precision medicine for prostate cancer patients in the near future.
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Affiliation(s)
- Naoki Terada
- Department of Urology, Kyoto University, Kyoto, Japan
| | | | | | | | - Osamu Ogawa
- Department of Urology, Kyoto University, Kyoto, Japan
| | - Emmanuel S Antonarakis
- Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, 1650 Orleans Street, CRB1-1M45, Baltimore, MD 21287, USA
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24
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Ikeguchi M, Hanaki T, Endo K, Suzuki K, Nakamura S, Sawata T, Shimizu T. C-Reactive Protein/Albumin Ratio and Prognostic Nutritional Index Are Strong Prognostic Indicators of Survival in Resected Pancreatic Ductal Adenocarcinoma. J Pancreat Cancer 2017; 3:31-36. [PMID: 30631838 PMCID: PMC5933481 DOI: 10.1089/pancan.2017.0006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Purpose: We evaluated the clinical importance, such as the occurrence of postoperative pancreatic fistula (POPF) or prognosis, of preoperative serum markers of chronic inflammation, nutrition, and immunity, as well as that of serum tumor markers after curative resection of pancreatic ductal adenocarcinomas (PDACs). Methods: Between 2006 and 2015, 43 patients with PDACs underwent curative resection at Tottori Prefectural Central Hospital. We analyzed which preoperative indicators (i.e., C-reactive protein/albumin ratio [CAR], neutrophil/lymphocyte ratio [NLR], prognostic nutritional index [PNI], carcinoembryonic antigen [CEA], and carbohydrate antigen 19-9 [CA 19-9]) were the most relevant risk factors for occurrence of POPF and poor patient survival. Results: POPF was detected in 8/43 (18.6%) patients. One patient died of pancreatic fistula at 2 months postoperatively. Among nine candidate factors (operative procedure, operation time, tumor stage, preoperative serum amylase, preoperative CAR, NLR, PNI, CEA, and CA 19-9), we did not identify any significant risk factor for the occurrence of POPF. The 5-year overall survival (OS) rate of the 43 patients was 22.4%, and the overall median survival time was 21 months. The multivariate OS analysis demonstrated that high CAR and low PNI were strong preoperative markers of poor prognosis independently of tumor stage. Conclusions: Preoperative CAR and PNI are useful prognostic markers for patients with operable PDACs.
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Affiliation(s)
- Masahide Ikeguchi
- Department of Surgery, Tottori Prefectural Central Hospital, Tottori, Japan
| | - Takehiko Hanaki
- Department of Surgery, Tottori Prefectural Central Hospital, Tottori, Japan
| | - Kanenori Endo
- Department of Surgery, Tottori Prefectural Central Hospital, Tottori, Japan
| | - Kazunori Suzuki
- Department of Surgery, Tottori Prefectural Central Hospital, Tottori, Japan
| | - Seiichi Nakamura
- Department of Surgery, Tottori Prefectural Central Hospital, Tottori, Japan
| | - Takashi Sawata
- Department of Surgery, Tottori Prefectural Central Hospital, Tottori, Japan
| | - Tetsu Shimizu
- Department of Surgery, Tottori Prefectural Central Hospital, Tottori, Japan
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25
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Mochizuki T, Kawahara T, Takamoto D, Makiyama K, Hattori Y, Teranishi JI, Miyoshi Y, Yumura Y, Yao M, Uemura H. The neutrophil-to-lymphocyte ratio (NLR) predicts adrenocortical carcinoma and is correlated with the prognosis. BMC Urol 2017; 17:49. [PMID: 28662713 PMCID: PMC5490233 DOI: 10.1186/s12894-017-0240-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 06/21/2017] [Indexed: 01/02/2023] Open
Abstract
Background The neutrophil-to-lymphocyte ratio (NLR) is reported as a biomarker for some solid malignant diseases. Thus far, however, no reports of the relationship between the NLR and adrenal tumors have been published. We analyzed the utility of the preoperative NLR as a biomarker for predicting the prognosis or diagnosis of malignant disease. Methods A total of 59 patients with adrenal tumors (13 cases of malignant disease and 46 with benign disease) were analyzed in this study from February 2004 to June 2015 at our institute. The NLR was obtained just before adrenalectomy. The diagnosis of adrenal tumor was confirmed by a pathological examination of surgical specimens. Results The NLR in malignant adrenal tumor specimens was significantly higher than in non-malignant specimens (p = 0.028). Adrenocortical carcinoma (ACC) showed the highest NLR among all adrenal tumors. In ACC, the higher NLR group (NLR ≥ 5) showed a significantly poorer overall survival than the lower NLR group (NLR < 5) (p = 0.032). Conclusions In adrenal tumors, a higher NLR indicates a higher incidence of malignancy. The NLR might be a new biomarker for predicting the prognosis of adrenal tumor patients.
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Affiliation(s)
- Taku Mochizuki
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 2320024, Japan
| | - Takashi Kawahara
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 2320024, Japan. .,Department of Urology, Yokohama City University, Graduate School of Medicine, Yokohama, Japan.
| | - Daiji Takamoto
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 2320024, Japan
| | - Kazuhide Makiyama
- Department of Urology, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Yusuke Hattori
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 2320024, Japan
| | - Jun-Ichi Teranishi
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 2320024, Japan
| | - Yasuhide Miyoshi
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 2320024, Japan
| | - Yasushi Yumura
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 2320024, Japan
| | - Masahiro Yao
- Department of Urology, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Hiroji Uemura
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 2320024, Japan
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26
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Huang TB, Mao SY, Lu SM, Yu JJ, Luan Y, Gu X, Liu H, Zhou GC, Ding XF. Predictive value of neutrophil-to-lymphocyte ratio in diagnosis of prostate cancer among men who underwent template-guided prostate biopsy: A STROBE-compliant study. Medicine (Baltimore) 2016; 95:e5307. [PMID: 27858908 PMCID: PMC5591156 DOI: 10.1097/md.0000000000005307] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
To evaluate the predictive value of neutrophil-to-lymphocyte ratio (NLR) in diagnosis of prostate cancer (PCa). Data of 662 patients who underwent prostate biopsy from January 2012 to June 2016 were retrospectively reviewed. The receiver operating characteristic-derived area under the curve analyses were performed to assess the predictive accuracy. Simultaneously, Youden's index was calculated to determine the optimal NLR cutoff. Furthermore, univariate and multivariate logistic regression analyses were performed to determine the association between NLR value and PCa detection. On account of an NLR value of 2.44 was shown with the maximal Youden's index on the receiver operating characteristic curve, the cutoff value of NLR was set at 2.44. Accordingly, patients were classified into high-NLR or low-NLR group. The patients in high-NLR group might have significant higher risk to be diagnosed with PCa (HR 1.640; P = 0.031), especially in the subgroup with prostate-specific antigen (PSA) ranged from 4 to 10 ng mL (hazard ratio [HR] 4.364; P = 0.003). The high-NLR was independent of age of diagnosis, PSA, prostate volume, abnormal digital rectal examination, and hypoechoic lesion on transrectal ultrasound for positive prostate biopsy. In the so-called gray area, combination of NLR value could raise 4.6% of the accuracy of the multivariate logistic model in PCa prediction, but not in advanced PCa prediction.The patients with high-NLR value may have significant higher risk to be diagnosed with PCa, especially among the patients with PSA ranged from 4 to 10 ng mL. In this subgroup, the adding of NLR value in the multivariate model can improve the accuracy of PCa prediction in a large degree. If validated, the NLR will become a promising, accessible, inexpensive biomarker for PCa prediction.
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Affiliation(s)
- Tian-bao Huang
- Department of Urology, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China
- Department of Urology, College of Clinical Medicine, Yangzhou, Jiangsu Province, China
| | - Shi-yu Mao
- Department of Urology, Shanghai Tenth People's Hospital, Shanghai, China
| | - Sheng-ming Lu
- Department of Urology, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China
- Department of Urology, College of Clinical Medicine, Yangzhou, Jiangsu Province, China
| | - Jun-jie Yu
- Department of Urology, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China
- Department of Urology, College of Clinical Medicine, Yangzhou, Jiangsu Province, China
| | - Yang Luan
- Department of Urology, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China
- Department of Urology, College of Clinical Medicine, Yangzhou, Jiangsu Province, China
| | - Xiao Gu
- Department of Urology, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China
- Department of Urology, College of Clinical Medicine, Yangzhou, Jiangsu Province, China
| | - Hao Liu
- Department of General Surgery, Northern Jiangsu People's Hospital, Yangzhou University, Yangzhou, Jiangsu Province, China
| | - Guang-chen Zhou
- Department of Urology, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China
- Department of Urology, College of Clinical Medicine, Yangzhou, Jiangsu Province, China
- Correspondence: Xue-fei Ding, No. 98 West Nantong Road, Yangzhou, 225001, Jiangsu Province, China (e-mail: ); Guang-chen Zhou, No. 98 West Nantong Road, Yangzhou, 225001, Jiangsu Province, China (e-mail: )
| | - Xue-fei Ding
- Department of Urology, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China
- Department of Urology, College of Clinical Medicine, Yangzhou, Jiangsu Province, China
- Correspondence: Xue-fei Ding, No. 98 West Nantong Road, Yangzhou, 225001, Jiangsu Province, China (e-mail: ); Guang-chen Zhou, No. 98 West Nantong Road, Yangzhou, 225001, Jiangsu Province, China (e-mail: )
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27
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Chua MLK, Tan SH, Kusumawidjaja G, Shwe MTT, Cheah SL, Fong KW, Soong YL, Wee JTS, Tan TWK. Neutrophil-to-lymphocyte ratio as a prognostic marker in locally advanced nasopharyngeal carcinoma: A pooled analysis of two randomised controlled trials. Eur J Cancer 2016; 67:119-129. [PMID: 27640138 DOI: 10.1016/j.ejca.2016.08.006] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 07/17/2016] [Accepted: 08/10/2016] [Indexed: 12/31/2022]
Abstract
PURPOSE To assess the prognostic value of neutrophil-to-lymphocyte ratio (NLR) in patients with International Union Against Cancer (UICC)-staged III/IVA,B nasopharyngeal carcinoma (NPC), who were enrolled into two randomised controlled trials of concurrent/adjuvant chemotherapy when added to radiotherapy (SQNP01), and induction chemotherapy when added to chemoradiotherapy (NCC0901). MATERIAL AND METHODS A post hoc analysis of pooled cohorts from SQNP01 (N = 221) and NCC0901 (N = 172) was performed. We employed a threshold of pre-treatment NLR = 3.0 (median) to stratify patients. Survival outcomes were compared using log-rank test. Multivariable Cox regression analyses were performed to assess association between NLR and overall survival (OS), disease-free survival (DFS), distant metastasis-free survival (DMFS), and locoregional recurrence-free survival (LRFS). RESULTS High NLR (≥3.0) was associated with advanced T-status (p = 0.002), N-status (p = 0.002), overall UICC stage (p = 0.004), and high pre-treatment Epstein-Barr virus DNA titre (p = 0.001). High NLR was not associated with OS (0.94 [0.67-1.32], p = 0.7), DFS (0.98 [0.73-1.33], p = 0.9), DMFS (1.02 [0.66-1.57], p = 0.9), and LRFS (1.37 [0.84-2.22], p = 0.2) on univariable and multivariable analyses, while conventional clinical indices (T-status, N-status, and overall UICC stage) were prognostic of clinical outcomes. High NLR also did not predict for a treatment effect with the experimental arms in both trials. CONCLUSION Our pooled analyses that were confined to a homogenous patient population of locally advanced NPC do not suggest that NLR adds prognostic value to conventional clinical indices in identifying patients with unfavourable disease.
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Affiliation(s)
- Melvin Lee Kiang Chua
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore; Duke-NUS Graduate Medical School, Singapore, Singapore.
| | - Sze Huey Tan
- Division of Clinical Trials and Epidemiological Sciences, National Cancer Centre Singapore, Singapore, Singapore
| | - Grace Kusumawidjaja
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Ma Than Than Shwe
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Shie Lee Cheah
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Kam Weng Fong
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore; Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Yoke Lim Soong
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore; Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Joseph Tien Seng Wee
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore; Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Terence Wee Kiat Tan
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore; Duke-NUS Graduate Medical School, Singapore, Singapore
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28
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Cao J, Zhu X, Zhao X, Li XF, Xu R. Neutrophil-to-Lymphocyte Ratio Predicts PSA Response and Prognosis in Prostate Cancer: A Systematic Review and Meta-Analysis. PLoS One 2016; 11:e0158770. [PMID: 27368058 PMCID: PMC4930176 DOI: 10.1371/journal.pone.0158770] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 06/17/2016] [Indexed: 02/07/2023] Open
Abstract
An unprecedented advance has been seen in castration-resistant prostate cancer (CRPC) treatments in the past few years. With a number of novel agents were approved, there is a pressing need to develop improved prognostic biomarkers to facilitate the personalised selection and sequencing of these novel agents. Emerging evidence indicates that the neutrophil-to-lymphocyte ratio (NLR) is associated with poorer survival in patients with prostate cancer (PCa). However, the importance of the NLR for the prediction of the PSA response (PSARS) and biochemical recurrence (BCR) has been largely neglected. Here, we conducted a systematic review and meta-analysis to evaluate the prognostic value of the NLR for the PSARS, BCR, and survival in PCa. A systematic database search was performed using Embase, PubMed, the Cochrane Library, and the China National Knowledge Infrastructure (CNKI). A meta-analysis was performed by pooling hazard ratios (HRs), odds ratios (ORs) and the corresponding 95% confidence intervals (CIs). A total of 22 studies were included in the meta-analysis. Our results suggest that an elevated NLR predicts a lower PSARS rate (OR = 1.69, 95% CI: 1.40–1.98) and a higher possibility of BCR (HR = 1.12, 95% CI: 1.02–1.21). Additionally, we confirmed that an elevated NLR was a prognostic predictor of shorter overall survival (OS) in both metastatic castration-resistant PCa (mCRPC) (HR = 1.45, 95% CI: 1.32–1.59) and localized PCa (LPC) (HR = 1.12, 95% CI: 1.01–1.23) and that it predicted worse progression-free survival (PFS) in CRPC (HR = 1.42, 95% CI: 1.23–1.61) and poorer recurrence-free survival (RFS) (HR = 1.38, 95%CI: 1.01–1.75) in LPC. Our results suggest that an elevated NLR might be employed as a prognostic marker of biochemical changes and prognosis to facilitate risk stratification and decision making for individual treatment of PCa patients. The potential mechanisms underlying these associations and future research directions are also discussed.
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Affiliation(s)
- Jian Cao
- Department of Urology, The Second Xiangya Hospital, Central South University, Hunan Province, People’s Republic of China
- MRC Centre for Reproductive Health, Queen’s Medical Research Institute, Edinburgh, United Kingdom
| | - Xuan Zhu
- Department of Urology, The Second Xiangya Hospital, Central South University, Hunan Province, People’s Republic of China
| | - Xiaokun Zhao
- Department of Urology, The Second Xiangya Hospital, Central South University, Hunan Province, People’s Republic of China
| | - Xue-Feng Li
- MRC Centre for Reproductive Health, Queen’s Medical Research Institute, Edinburgh, United Kingdom
| | - Ran Xu
- Department of Urology, The Second Xiangya Hospital, Central South University, Hunan Province, People’s Republic of China
- * E-mail:
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