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ABSTRACT: Background
Inflammation-scores based on general inflammation markers are suggested as prognostic markers of overall survival (OS) in lung cancer. However, whether these inflammation-scores improves the prognostication performed by well-established prognostic markers is unsettled. In a large register-based lung cancer patient cohort, nine different inflammation-scores were compared, and their ability to optimize the prognostication of OS was evaluated.Methods
Lung cancer patients diagnosed from 2009-2018 in The Central Denmark Region were identified in the Danish Lung Cancer Registry. Pre-treatment inflammation markers were extracted from the clinical laboratory information system. Prognostication of OS was evaluated by Cox proportional hazard models. Comparison of the inflammation-scores and their added value to established prognostic markers were assessed by Akaike's information criteria and Harrel's C-index.Results
In total, 5,320 patients with non-small cell lung cancer (NSCLC) and 890 patients with small cell lung cancer (SCLC) were identified. In NSCLC, the Aarhus composite biomarker score (ACBS), including albumin, C-reactive protein, neutrophil count, lymphocyte count and haemoglobin, and the neutrophil-lymphocyte-ratio (NLR) were superior. Furthermore, they improved the prognostication of OS significantly (p <0.0001) (ACBS: HR: 2.24 (95%CI: 1.97-2.54); NLR: HR: 1.58 (95%CI: 1.47 - 1.69)). In SCLC, three scores were equally superior and improved the prognostication of OS p < 0.0001): neutrophil-lymphocyte-ratio (HR:1.62 (95%CI: 1.38-1.90)), modified Glasgow Prognostic Score (mGPS) (HR:1.70 (95%CI: 1.55-1.86) and the Combined NLR and GPS (CNG) (HR:2.10 (95%CI: 1.77-2.49).Conclusions
The ACBS was the optimal score in NSCLC, whereas neutrophil-lymphocyte-ratio, mGPS and CNG were equally superior in SCLC. Additionally, these inflammation-scores all optimised the prognostication of OS and added value to well-established prognostic markers.
SUBMITTER: Winther-Larsen A
PROVIDER: S-EPMC8759208 | biostudies-literature |
REPOSITORIES: biostudies-literature