Preoperative Hematologic Inflammatory Markers as Prognostic Factors in Patients with Glioma

Abstract

Hematologic inflammatory markers are simple, inexpensive prognostic markers for various conditions. The prognostic significance of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and red blood cell distribution width (RDW) has been shown in a variety of tumors. We evaluated the prognostic value of these markers in glioma. We performed a retrospective medical record review of 219 patients with glioma from January 2012 to January 2017, evaluating the effect of NLR, PLR, MLR, and RDW on prognosis. Correlations among these hematologic inflammatory markers were also examined. The patients were divided into high and low groups using the cutoff points from the receiver operating characteristic curves. High NLR was associated with a higher tumor grade (P= 0.000). Kaplan-Meier survival analyses showed that the high NLR, PLR, and MLR groups experienced inferior median overall survival (OS) compared with the low NLR, PLR, and MLR groups (11 vs. 32 months; P= 0.000; 12 vs. 21 months; P= 0.001; and 12 vs. 22 months; P= 0.006, respectively). No significant difference was found in the median OS between the high and low RDW groups (15 vs. 23 months; P= 0.184). Multivariate analysis demonstrated that NLR was an independent predictor of OS (hazard ratio, 1.758; P= 0.008). A high preoperative NLR, PLR, and MLR was predictive of a poor prognosis for patients with glioma. NLR was an independent prognostic factor for OS in patients with glioma.