TY - JOUR
T1 - Prognostic Significance of Neutrophil-to-Lymphocyte Ratio in Locally Advanced Non-small-cell Lung Cancer Treated with Trimodality Therapy
AU - Tsudaka, Shimpei
AU - Yamamoto, Hiromasa
AU - Sato, Hiroki
AU - Katsui, Kuniaki
AU - Suzawa, Ken
AU - Shien, Kazuhiko
AU - Miyoshi, Kentaroh
AU - Otani, Shinji
AU - Okazaki, Mikio
AU - Sugimoto, Seiichiro
AU - Yamane, Masaomi
AU - Kiura, Katsuyuki
AU - Kanazawa, Susumu
AU - Toyooka, Shinichi
N1 - Funding Information:
This work was supported by a Management Expenses Grant for National University Corporations in Japan. We would like to thank Editage ( http://www.editage.com ) for English language editing.
Funding Information:
This work was supported by a Management Expenses Grant for National University Corporations in Japan.
Publisher Copyright:
© 2021, Society of Surgical Oncology.
PY - 2021/9
Y1 - 2021/9
N2 - Purpose: Current evidence suggests that the neutrophil-to-lymphocyte ratio (NLR) is a prognostic factor in several types of cancer. In this study, we aimed to evaluate the prognostic impact of clinicopathological factors, including postoperative NLR, in patients with locally advanced non-small-cell lung cancer (LA-NSCLC) who underwent surgery after chemoradiotherapy (CRT) with or without postoperative adjuvant chemotherapy. Methods: The medical records of LA-NSCLC patients treated with trimodality therapy at our institution between June 1999 and May 2019 were reviewed. The association between several clinicopathological factors and overall survival (OS) was analyzed. Results: A total of 168 patients were included in this study. Regarding the prognosis, the 5-year OS rate was 68.1%, and the 2-year recurrence-free survival rate was 66.1% in the entire population. In multivariate analysis, we identified that high postoperative NLR, not pretreatment or preoperative NLR, was one of the independent factors for unfavorable OS (NLR high vs NLR low; hazard ratio = 2.45, 95% confidence interval: 1.53–3.94, p < 0.001). In addition, among patients with high postoperative NLR, patients who received postoperative adjuvant chemotherapy showed significantly better 5-year OS compared with those who did not (p = 0.016). On the other hand, postoperative adjuvant chemotherapy had no impact on the prognosis in patients with low NLR (p = 0.19). Conclusions: Our results suggest that high postoperative NLR was not only an independent unfavorable prognostic factor in patients with LA-NSCLC who were treated with trimodality therapy, but also a promising indicator for postoperative treatment in this population.
AB - Purpose: Current evidence suggests that the neutrophil-to-lymphocyte ratio (NLR) is a prognostic factor in several types of cancer. In this study, we aimed to evaluate the prognostic impact of clinicopathological factors, including postoperative NLR, in patients with locally advanced non-small-cell lung cancer (LA-NSCLC) who underwent surgery after chemoradiotherapy (CRT) with or without postoperative adjuvant chemotherapy. Methods: The medical records of LA-NSCLC patients treated with trimodality therapy at our institution between June 1999 and May 2019 were reviewed. The association between several clinicopathological factors and overall survival (OS) was analyzed. Results: A total of 168 patients were included in this study. Regarding the prognosis, the 5-year OS rate was 68.1%, and the 2-year recurrence-free survival rate was 66.1% in the entire population. In multivariate analysis, we identified that high postoperative NLR, not pretreatment or preoperative NLR, was one of the independent factors for unfavorable OS (NLR high vs NLR low; hazard ratio = 2.45, 95% confidence interval: 1.53–3.94, p < 0.001). In addition, among patients with high postoperative NLR, patients who received postoperative adjuvant chemotherapy showed significantly better 5-year OS compared with those who did not (p = 0.016). On the other hand, postoperative adjuvant chemotherapy had no impact on the prognosis in patients with low NLR (p = 0.19). Conclusions: Our results suggest that high postoperative NLR was not only an independent unfavorable prognostic factor in patients with LA-NSCLC who were treated with trimodality therapy, but also a promising indicator for postoperative treatment in this population.
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U2 - 10.1245/s10434-021-09690-9
DO - 10.1245/s10434-021-09690-9
M3 - Article
C2 - 33634385
AN - SCOPUS:85101578853
SN - 1068-9265
VL - 28
SP - 4880
EP - 4890
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
IS - 9
ER -
