Prognostic value of the advanced lung cancer inflammation index in early-stage non-small cell lung cancer patients undergoing video-assisted thoracoscopic pulmonary resection.

Abstract

The aim of this study was to assess the prognostic value of the preoperative advanced lung cancer inflammation index (ALI) in early stage non-small lung cancer (NSCLC) patients who received videoassisted thoracoscopic surgery (VATS) pulmonary surgery as their only therapy. We retrospectively reviewed the medical records of patients who were diagnosed with earlystage NSCLC and received a VATS pulmonary resection from January 2014 to June 2016 in the Department of Thoracic Surgery, West China Hospital. A receiver operating characteristic (ROC) curve analysis was conducted to determine the optimal cut-off values, and patients were divided into low and high ALI groups. The Kaplan-Meier method and Cox proportional hazards model were used to evaluate potential predictors of overall survival (OS) and disease-free survival (DFS). A total of 292 patients were enrolled in our analysis. Then, 155 and 137 patients were assigned to the low ALI (ALI <50) and high (ALI >50) groups, respectively. The multivariate analyses revealed that preoperative ALI <50 was an independent prognostic factor for both OS [hazard ratio (HR) = 2.603, 95% confidence interval (95% CI): 1.128-6.006, P=0.025] and DFS (HR =2.372, 95% CI: 1.141-4.935, P=0.021), and patients with a low preoperative ALI had worse OS (P<0.001) and DFS (P<0.001) compared with those with a high preoperative ALI. A low preoperative ALI was significantly correlated with poor survival, and the ALI might serve as a promising marker of prognosis in early-stage NSCLC patients who received a VATS pulmonary resection as their only therapy.