P1.18-20 The Relationship Between the Recurrence Timing and Inflammation-Based Prognostic Scores in Resected Non-Small-Cell Lung Cancer

Abstract

Several inflammatory markers are reported to be useful in predicting the surgical outcomes in patients with various cancers. We evaluated the influence of inflammation-based prognostic scores on the postoperative recurrence timing using survival curves and hazard curves for non-small cell lung cancer (NSCLC) patients. Total 356 patients with NSCLC who underwent pulmonary resection were retrospectively studied. The study subjects included 217 males and 139 females with a mean age of 70.0 years at the time of the surgery. We divided the population as per the Glasgow prognostic score (GPS), modified GPS, neutrophil-to-lymphocyte ratio (NLR, cut-off: low ≤3.75 and high >3.75), platelet-to-lymphocyte ratio[A1] (low ≤200 and high >200), and C-reactive protein-to-albumin ratio (CAR, low ≤0.028 and high >0.028). Hazard curves and changes in the hazards [A2] over time were evaluated. GPS, mGPS, high NLR, and high CAR were significantly associated with poor recurrence-free survival (RFS) in the univariate analysis. Multivariate analysis revealed that only mGPS (Hazard ratio [HR]: 1.569, 95% confidence interval [CI] 1.149–2.144, p = 0.005) and high CAR (HR: 1.751, 95%CI 1.002–3.061, p = 0.049) remained independently associated with RFS. The resulting hazard curves indicated that the recurrence risk pattern correlated with inflammation, with an early sharp peak within a year of surgery for patients with mGPS 2 or a high CAR and some late gentle humps [A1] for patients with mGPS 0 or a low CAR. Patients with mGPS 2 or a high CAR have a high risk of early recurrence in resected NSCLC. These findings are useful for postoperative follow-up strategy, allowing the identification of patients who would specifically obtain a clinical benefit from intensive surveillance.