Peripheral Blood Lymphocytes and Platelets Are Prognostic in Surgical pT1 Non-Small Cell Lung Cancer

Abstract

There is a paucity of prognostic factors for patients with stage I non-small cell lung cancer (NSCLC) undergoing operations. We investigated the prognostic role of preoperative complete blood count values in patients with stage I NSCLC patients undergoing operations. A retrospective medical record review was performed of patients who underwent operations for stage I NSCLC between 2000 and 2015. Patients who died within 30 days of the operations were excluded. The primary end point was recurrence. Preoperative complete blood count values were analyzed, and a median value was used as the cutoff. Statistical analysis used χ2 and t tests along with univariate and multivariate analyses by Cox regression modeling. The study included 103 patients. A high lymphocyte count was significantly associated with recurrence (5-year recurrence-free survival [RFS] of 69.8% for high vs 95.7% for low, P= .003), as well as high platelet (5-year RFS of 72.0% for high vs 91.8% for low, P= .02). Independent prognostic factors on multivariate analysis were high lymphocyte (hazard ratio [HR], 7.27; P= .005) and platelet counts (HR, 7.49; P= .003) as well as tumor (HR, 5.40; P= .008) and treatment characteristics (HR, 4.59; P= .01). Among patients with pT1 lesions, high lymphocyte (HR, 8.41; P= .03) and high platelet counts (HR, 19.78; P= .004) remained independent prognostic factors. Neither NLR nor PLR were significantly associated with recurrence. In patients with pathologic stage I NSCLC undergoing surgical resection, the preoperative blood count from peripheral blood may provide prognostic value. Of significance, in patients with pT1 N0 NSCLC, high lymphocyte count and high platelet count were associated with higher recurrence.