Impact of Age on Inflammation-Based Scores among Patients Diagnosed with Stage III Non-Small Cell Lung Cancer

Abstract

Background: Inflammatory and nutritional indexes are prognostic factors in non-small cell lung cancer (NSCLC). Furthermore, a low grade of chronic inflammation has been described in the older population (inflammaging). We aimed to evaluate the neutrophil-to-lymphocyte ratio (NLR), the Prognostic Nutritional Index (PNI), the advanced lung cancer inflammation index (ALI), the platelet-to-lymphocyte ratio (PLR), and the Glasgow Prognostic Score (GPS) in young and older patients diagnosed with locally advanced NSCLC to determine if significant differences between these groups exist. Methods: We conducted a retrospective study analyzing the impact of age on the NLR, PNI, ALI, PLR, and GPS among patients diagnosed with stage III NSCLC at Hospital Universitario Doctor Peset between 2010 and 2015. Results: We included 124 patients (84 young, 40 older patients). The median hemoglobin level and leukocyte count were lower in the older patients (p = 0.0158 and p = 0.001, respectively). A higher median C-reactive protein level was also found in this group (p = 0.0095). Regarding specific inflammatory indexes, the PNI, comprising inflammatory and nutritional parameters, was lower among the older patients (p = 0.0463). The median NLR, ALI, and PLR were similar in both age groups. Moreover, no differences between the age groups were found in the percentage of patients showing high versus low NLR (cutoff point, 5) or ALI (cutoff point, 18) or in the different GPS groups. Conclusions: The baseline PNI, hemoglobin level, and lymphocyte count were lower among the older patients; furthermore, CRP was higher, possibly, because of a more prominent inflammatory status in older patients with lung cancer. No other immunological or nutritional analytical variables were different between the age groups.