The Prognostic Significance of Preoperative Platelet-to-Lymphocyte and Neutrophil-to-Lymphocyte Ratios in Patients Operated for Non-Small Cell Lung Cancer

Mariusz Łochowski; Justyna Chałubińska-Fendler; Izabela Zawadzka; Barbara Łochowska; Marek Rębowski; Daniel Brzeziński; Józef Kozak

doi:10.2147/CMAR.S317705

The Prognostic Significance of Preoperative Platelet-to-Lymphocyte and Neutrophil-to-Lymphocyte Ratios in Patients Operated for Non-Small Cell Lung Cancer

Cancer Manag Res. 2021 Oct 9:13:7795-7802. doi: 10.2147/CMAR.S317705. eCollection 2021.

Authors

Mariusz Łochowski¹, Justyna Chałubińska-Fendler², Izabela Zawadzka³, Barbara Łochowska⁴, Marek Rębowski¹, Daniel Brzeziński¹, Józef Kozak¹

Affiliations

¹ Clinic of Thoracic Surgery and Respiratory Rehabilitation, Medical University of Lodz, Lodz, Poland.
² Department of Radiotherapy, Military Institute of Medicine, Warsaw, Poland.
³ "Synevo" Medical Laboratory, Regional Multi-Specialist Center for Oncology and Traumatology of the Nicolaus Copernicus Memorial Hospital in Lodz, Lodz, Poland.
⁴ Department of Radiotherapy and General Oncology, Regional Multi-Specialist Center for Oncology and Traumatology of the Nicolaus Copernicus Memorial Hospital in Lodz, Lodz, Poland.

Abstract

Introduction: The aim of the study was to determine the prognostic significance of PLR and NLR ratios in patients operated due to non-small cell lung cancer.

Material: The study group consisted of 532 (174 women, 358 men) patients with non-small cell lung cancer (NSCLC) staged IA-IIIA. The mean age was 63.6 years (range 36 to 84 years). Together with platelet/lymphocyte ratio (PLR) and neutrophil/lymphocyte ratio (NLR), the following factors were included in the statistical analysis: age, sex, smoking history, the number of leukocytes, neutrophils, and platelets, histopathology, T-stage, N-stage, concomitant diseases according to the Charlson Comorbidity Index (CCI), type of operation, adjuvant chemotherapy, and overall survival.

Results: Univariate analysis showed an association between the value of PLR and NLR and the length of survival. Multivariate analysis found that the stage of advancement of the neoplastic disease (p=0.00003), adjuvant chemotherapy (p=0.009), CCI > 4 (0.00008), and PLR > 144 (p=0.001) were negative prognostic factors for survival > 2 years; however, this effect diminishes in patients surviving more than 5 years.

Conclusion: PLR might serve as a prognostic factor in patients affected by NSCLC with expected two-year overall survival.

Keywords: carcinoma; lymphocyte count; neutrophil count; non-small-cell; platelet count; ratio.