Dataset Information

Significance of Pretreatment Neutrophil-to-Lymphocyte Ratio in Mucoepidermoid Carcinoma of Pediatrics: A Multicenter Study.

ABSTRACT: Background: Our goal was to analyze the value of the pretreatment neutrophil-to-lymphocyte ratio (NLR) in the prognosis of pediatrics with parotid mucoepidermoid carcinoma (MEC). Methods: Patients (? 18 years old) undergoing surgical treatment for primary parotid MEC were enrolled from multiple clinical centers retrospectively. The ?2-test was used to analyze the associations between clinicopathological variables and the NLR. The main study endpoints were recurrence-free survival (RFS) and disease-specific survival (DSS). The prognostic value of NLR was assessed by Kaplan-Meier method and Cox model analysis. Results: There were 88 patients included in total, with mean NLR of 2.32 (range, 1.8-6.0). Histologic tumor grade and tumor stage were associated with the NLR significantly. The 10-year RFS rates were 98 and 81% for patients with an NLR < 2.32 and patients with an NLR ? 2.32, respectively, the difference was significant (p = 0.010). The 10-year DSS rate was 97 and 81% for patients with an NLR < 2.32 and patients with an NLR ? 2.32, respectively; the difference was not significant (p = 0.072). The independence of NLR in predicting the RFS was further confirmed in Cox model analysis. Conclusion: The NLR significantly affects the prognosis in pediatrics with primary parotid MEC.

SUBMITTER: Gao H

PROVIDER: S-EPMC7120218 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Significance of Pretreatment Neutrophil-to-Lymphocyte Ratio in Mucoepidermoid Carcinoma of Pediatrics: A Multicenter Study.

Gao Hua H Gao Qing Q Sun Jinlan J

Frontiers in pediatrics 20200327

Background: Our goal was to analyze the value of the pretreatment neutrophil-to-lymphocyte ratio (NLR) in the prognosis of pediatrics with parotid mucoepidermoid carcinoma (MEC). Methods: Patients (≤ 18 years old) undergoing surgical treatment for primary parotid MEC were enrolled from multiple clinical centers retrospectively. The χ2-test was used to analyze the associations between clinicopathological variables and the NLR. The main study endpoints were recurrence-free ...[more]

PMID: 32292769

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Project description:Predicting survival of patients with malignant pleural effusions (MPEs) is notoriously difficult. A robust prognostic marker can guide clinical decision making. The neutrophil-to-lymphocyte ratio (NLR) in blood has been shown to predict survival in many cancers. Pleural fluid bathes the malignant pleural tissues, thus the NLR of the pleural fluid may reflect more closely the local tumour environment. The objective of this study was to explore the prognostic significance of pleural effusion NLR for MPE. We analysed matched effusion and blood from 117 patients with malignant and 24 with benign pleural effusions. Those who had received recent chemotherapy or had a pleurodesis were excluded. Neutrophil and lymphocyte counts in effusions were performed by manual review of cytospin cell preparations by trained observers. Clinical data were extracted from a state-wide hospital database. We found significantly fewer neutrophils (expressed as percentage of total leukocyte count) in pleural fluid than in corresponding blood (9% vs 73%; p<0.001). The NLR was an order of magnitude lower in pleural fluid than in corresponding blood: median [IQR] = 0.20 [0.04-1.18] vs 4.9 [3.0-8.3], p<0.001. Correlation between blood and pleural fluid NLR in MPE patients was moderate (rs = 0.321, p<0.001). In univariate analysis, NLR (>0.745)) in malignant pleural fluid was predictive of poorer survival (HR = 1.698 [1.0054-2.736]; p = 0.030), and remained significant after adjustment for age, sex, presence of a chest drain, cancer type, concurrent infection and subsequent treatment with chemotherapy (HR = 1.786 [1.089-2.928]; p = 0.022). Patients with pleural fluid NLR > 0.745 had a significantly shorter median survival of 130 (95% CI 0-282) days compared to 312 (95% CI 195-428) days for pleural NLR < 0.745, p = 0.026. The NLR in blood was also predictive of poorer survival in MPE patients (HR = 1.959 [1.019-3.096]; p<0.001). The proportion of neutrophils in pleural fluid was predictive of prognosis more strongly than lymphocytes. This study provides evidence that NLR in malignant effusions can predict survival, and therefore may provide prognostic information for this cohort. This prognostic association in the fluid is driven by the presence of neutrophils.

Project description:Elevated neutrophil-to-lymphocyte (NLR) and platelet-to-lymphocyte ratios (PLR) may represent markers of a suboptimal host immune response to cancer and have been shown to correlate with prognosis in multiple tumor types across different treatment modalities, including radiation therapy. Limited data suggest that NLR may predict for survival and disease control in patients receiving selective internal radiation therapy (SIRT). The correlation between clinical outcomes and change in NLR and PLR after SIRT has not been evaluated.We retrospectively reviewed 339 consecutive patients with primary (n=37) or metastatic (n=79) liver cancer treated with SIRT from 2006 to 2014. Complete blood counts with differential were available for 116 patients both before and after (median, 29 and 20 days, respectively) SIRT. Survival and progression were calculated from date of initial SIRT. Patient and tumor characteristics evaluated for ability to predict overall survival (OS) and progression free survival (PFS) included pre- and post-treatment neutrophil, platelet, and lymphocyte counts (LCs), as well as NLR, PLR, and relative change in NLR and PLR. Cutoff values were determined for variables that were significant on multivariate analysis (MVA) for OS and/or PFS.Median follow-up of surviving patients was 12 months. Median OS was 8 months from SIRT and 20 months from date of liver metastasis diagnosis. Significant factors on univariate analysis (UVA) for both lower OS and PFS included higher post-treatment neutrophil count (NC), higher post-treatment NLR, higher liver tumor volume, higher percentage liver tumor burden, and worse Eastern Cooperative Oncology Group (ECOG) performance status. Significant factors on MVA for lower OS and PFS were ECOG performance status ?2, higher liver tumor volume, higher pretreatment PLR, and increase in PLR after SIRT. Post-treatment increase in PLR >3-fold was the most predictive early marker for increased risk of death when compared with those whose PLR did not increase or increased <3-fold. Pretreatment PLR >78 was the most predictive serum marker associated with improved OS prior to therapy.This is the largest study to evaluate the association between NLR and PLR with clinical outcomes in patients receiving SIRT, with results that confirm that pre- and/or post-treatment NLR and/or PLR are predictive of clinical outcomes. The largest increase in risk of death as well as local and extrahepatic disease progression was related to change in PLR, a datum not well reported in the literature. The impact of SIRT on blood count changes and the underlying implications of these ratios should be further characterized in a prospective study.

Project description:BackgroundBreast cancer is a highly heterogeneous disease with large differences in the risk of recurrence. An elevated neutrophil-to-lymphocyte ratio (NLR) is correlated with a poor prognosis in a variety of tumors, and although it is still controversial in breast cancer, there are multiple studies, including meta-analysis, suggesting this. The purpose of this study was to analyze the prognostic value of preoperative NLR in an Argentine population of patients with nonmetastatic breast cancer, not exposed to neoadjuvant treatment.MethodsRetrospective multicenter cohort study that includes patients over 18 years of age from three centers in the city and province of Buenos Aires who have had surgery for early breast cancer between January 1, 1999, and December 31, 2014. Based on the previous literature, a cutoff value of 2.0 was defined.ResultsA total of 791 patients were eligible for the analysis. Median age was 55 years (IQR 45-65). Median NLR was 1.92 (IQR 1.50-2.56). The distribution of groups according to the 8th edition of the AJCC was 54.1% for stage I, 35.6% stage II, and 10.4% stage III. Among the different tumor phenotypes, 79.0% were HR+/HER2-, 11.4% were HR+ or-/HER2+, and 9.2% were HR-/HER2-. With a median follow-up of 5.3 years, 112 patients (14.2%) had disease recurrence. Stage III patients had a higher NLR than stage I and stage II patients (p = 0.002). The rest of the clinical and pathological characteristics did not show differences in the groups according to NLR. There were no differences in relapse-free survival according to the NLR (p = 0.37), and it did not change after adjusting for other prognostic variables.ConclusionWe consider it is important to determine the efficacy of prognostic markers that are easily accessible and of simple, systematic application. However, NLR does not appear to be an independent prognostic factor for recurrence in our population. In this sense, we consider it is important to publish negative results in order to avoid publication bias.

Dataset Information

Significance of Pretreatment Neutrophil-to-Lymphocyte Ratio in Mucoepidermoid Carcinoma of Pediatrics: A Multicenter Study.

Publications

Significance of Pretreatment Neutrophil-to-Lymphocyte Ratio in Mucoepidermoid Carcinoma of Pediatrics: A Multicenter Study.

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