Predictive value of preoperative peripheral lymphocyte count on recurrence of resectable non-small cell lung cancer.

Abstract

81 Background: Recently, the prognostic value of cancer-related inflammatory response has been revealed. Previous studies showed that peripheral neutrophils and lymphocytes had significant impact on the prognosis of advanced and early node-negative non-small cell lung cancer (NSCLC). The purpose of this study was to investigate the prognostic value of preoperative lymphocyte and neutrophil counts in patients with NSCLC who underwent radical surgery and adjuvant chemotherapy. Methods: Retrospective analyses were performed to examine the impact of preoperative peripheral lymphocyte and neutrophil counts on disease-free survival (DFS) and overall survival (OS) and to analyze the relationships of these factors to clinicopathological factors. Results: 142 patients with NSCLC were evaluated totally. 57 (40.1%) patients had local recurrence or metastasis. Multivariate analysesrevealed that peripheral lymphocyte count was an independent favorable prognostic factor of DFS (hazard ratio: 0.548; 95% confidence interval: 0.351-0.857; p=0.008) but not OS (p=0.164). The maximum log-rank statistical value was 9.504 (p=0.002) when the cutoff value of lymphocyte was 1800mm-3. The median DFS were 318.0 days (95% confidence interval: 226.0-410.0) for lymphocyte≤1800mm-3 group and 669.0 days (95% confidence interval: 0.0-1431.0) for lymphocyte>1800mm-3 group. Low lymphocyte count was related with lymphatic invasion (p=0.012) and recurrence of NSCLC (p=0.022). Peripheral neutrophil count had no impact on DFS or OS when analysis included all the 142 patients. In addition, T stage (p=0.001), N stage (p=0.001) and vascular invasion (p=0.021) were also independent unfavorable prognostic factors of DFS. Pathological stage (p=0.001), vascular invasion (p=0.011), and ECOG score (p=0.009) were independent unfavorable prognostic factor of OS. Conclusions: Preoperative peripheral lymphocyte count, which is related with lymphatic invasion, is an independent favorable prognostic factor of DFS in patients with NSCLC who underwent radical surgery and adjuvant chemotherapy.