The prognostic value of RDW, NLR and PLR in sequential radio-chemotherapy for advanced lung cancer

Abstract

Introduction.Inflammation plays an important role in carcinogenesis, therefore morphology-based inflammatory indi­ces could be prognostic factors in lung cancer patients. This study aimed to analyze if red cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) are associated with patients’ prognosis in non-small cell lung cancer (NSCLC) patients. Material and methods.The study population included 110 patients treated with definitive sequential radio-chemo­therapy for stage IIIA–IIIB NSCLC. The data were retrospectively analyzed using the receiver operating characteristic (ROC) method, Kaplan-Meier estimator, log-rank testing, and Cox proportional hazards regression model. Results.The ROC analysis has shown that the optimal cut-off values were 14% for RDW, 2.1 for NLR, and 120 for PLR, with area under the curve (AUC) of 0.606, 0.509, and 0.564 respectively. The overall survival was significantly higher in patients with RDW ≤ 14% with a median survival of 31.2 months compared to 20.2 months for patients with RDW > 14%. RDW was an independent prognostic factor in multivariate analysis. Conclusions.RDW can provide additional information in assessing patients’ prognosis, but it is necessary to consider its modest sensitivity and specificity. NLR and PLR were not found to be independent prognostic factors.