EP1.03-04 Analysis of Post-Surgical Systemic Inflammatory Indexes After Non-Small Cell Lung Cancer Surgical Intervention

Abstract

High NSCLC's mortality rates pushes the research of new prognostic indexes further tan TNM staging and could help in better treatment's selection. Neutrophil-Lymphocyte Ratio (NLR) preoperatively determined has demonstrated its relation with the immunologic status of the patient prior to the intervention and its capacity of “beating” tumor growing and its prognostic influence. OBJECTIVE: Evaluate the prognosis influence of NLR, Lymphocyte-Monocyte Ratio (LMR) and Platelet-Lymphocyte Ratio (PLR) in patients who underwent surgery for NSCLC with R0 resection and abscence of neoadjuvant treatment in peripheric blood determinations after surgery. A retrospective review of all consecutive patients operated on stage I to IIIA NSCLC from May 2014 – October 2018, completely resected and with no neoadjuvant treatment. Patients with previous oncologic history, haematologic neoplasms, perioperatory blood transfusion, perioperative infections or corticosteroids treatment were excluded. Peripheral blood determinations were taken during the first 6-months follow-up period. NLR, LMR and PLR were calculated. A descriptive analysis of demographic, tumor and surgical details is done. Overall survival (OS) was calculated since the date of surgery to date of death or last follow-up date. Disease-free survival (DFS) was calculated since the date of surgery to the date of recurrence. The discrimination capacity of the ratios was assessed with the calculation of the area under the ROC curve [AUC (CI 95%)]. The relationship among relevant clinico-pathological variables, DFS and OS was calculated. Analysis of recurrence risk factors with univariate and multivariate binary logistic regression (LR) OR(95%CI) was performed. 86 patients were included in the analysis. Median follow-up time was 45.7 months. Median OS and DFS were 27 and 24 months respectively. The AUC values of NLR [0.59(0,44-0,74)] and PLR [0,61(0,45-0,76] were not statistically significant, but value of LMR was significant with [0,70(0,57-0,83)]. The LR model found as factors associated with a higher probability of recurrence adjusted by sex and age: the value of LMR with OR=0,38 (0,20-0,73) and a higher stage than the OR=11,3 (1,89-67.5). Conversely to other publications, in our study the results showed the only relationship between LMR, tumor stage and risk of recurrence.