Predicting Overall Survival With Neutrophil-Lymphocyte Ratio in NSCLC

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NLR can be used to predict overall survival in patients with locally advanced, non-small cell lung cancer.
NLR can be used to predict overall survival in patients with locally advanced, non-small cell lung cancer.

Baseline neutrophil-lymphocyte ratio (NLR) is prognostic for overall survival among patients with locally advanced non-small cell lung cancer (NSCLC), according to a study published in The Oncologist.1

NLR, calculated by dividing the absolute neutrophil count by the absolute lymphocyte count, is a marker for systemic inflammation, which is linked to poor prognosis in NSCLC. For this retrospective study, researchers evaluated data from 276 patients with stage III NSCLC to determine whether NLR is prognostic for survival.

The median age among included patients was 60 years and about 90% of patients had an ECOG performance status of 0-1. All patients were treated with chemoradiation; 256 patients received concurrent and 18 received sequential chemoradiation. Eighty-five of the patients also underwent surgery.

NLRs were divided into quartiles: first, NLR of 2.12 or lower; second, NLR greater than 2.12 but less than or equal to 3.22; third, NLR greater than 3.22 and less than or equal to 5.18; fourth, NLR greater than 5.18.

Median overall survival lengths were: 27 months for the first quartile, 28 months for the second quartile, 22 months for the third quartile, and 10 months for the fourth quartile.

The prognostic marker held after adjusting for variables including chemoradiation approach and performance status.

According to the study's authors, “NLR is an inexpensive biomarker that may provide clinicians with valuable information regarding a patient's predicted life expectancy at the time of LANSCLC [locally advanced NSCLC] diagnosis.”

Reference

Scilla KA, Bentzen SM, Lam VK, et al. Neutrophil-lymphocyte ratio is a prognostic marker in patients with locally advanced (stage IIIA and IIIB) non-small cell lung cancer treated with combined modality therapy. Oncologist. 2017;22(6):737-742. doi:10.1634/theoncologist.2016-0443

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