Neutrophil to lymphocyte ratio (NLR) as a predictor of poor prognosis in advanced non-small cell lung cancer

Abstract

There is increasing evidence to suggest that neutrophil-to-lymphocyte ratio (NLR) is an independent predictor of poor outcome in patients with cancer. The aim of our study was to determine the association between baseline NLR and prognosis in patients with advanced inoperable non-small cell lung cancer (NSCLC). Methods: All patients with a new diagnosis of advanced inoperable NSCLC (stages III and IV) presenting at our thoracic oncology department between January 2005 and January 2013 (n = 142) were included. To evaluate the independent prognostic relevance of the NLR, univariate and multivariate Cox regression models were used. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Results: Median age was 60 years, all patients were male, and 50.2% had adenocarcinoma. The median NLR value was 3.42 (ranged between 0.11 and 25.06). High NLR was significantly associated with tumor metastasis (P = 0.028), high C-reactive protein (P = 0.0001), and low albumin (P = 0.0001).Patients with an NLR ≥3.42 showed a significantly lower PFS (P =0 .008) and OS (P = 0.04) than patients with an NLR Conclusion: Elevated NLR indicates a poor prognosis for patients with advanced NSCLC. It potentially represents a simple, easily-obtained, low cost and reliable biomarker with prognostic potential for advanced NSCLC.