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Relationship Between Prognosis and Neutrophil: Lymphocyte and Platelet:Lymphocyte Ratios in Patients with Malignant Pleural Mesotheliomas

  • Cihan, Yasemin Benderli (Department of Radiation Oncology, Kayseri Education and Research Hospital) ;
  • Ozturk, Ahmet (Department of Biostatistics, Erciyes University Faculty of Medicine) ;
  • Mutlu, Hasan (Department of Medical Oncology, Kayseri Acibadem Hospital)
  • Published : 2014.03.01

Abstract

Background: It has been demonstrated that neutrophil:lymphocyte (NLR) and platelet:lymphocyte (PLR) ratios are associated with prognosis in cancer patients. The aim of this study was to investigate whether pretreatment white blood cell (WBC), neutrophil, lymphocyte, monocyte, platelet, basophil and eosinophil counts, LDH level, NLR and PLR are associated with prognosis in patients with malignant pleural mesothelioma (MPM). Materials and Methods: We retrospectively reviewed files of 50 patients who were managed with a diagnosis of MPM between 2005 and 2010. Demographic and clinical characteristics, treatments, response to treatment and prognostic factors were evaluated, along with relationships between pretreatment blood parameters and prognosis. Results: Overall, 38 men and 12 women were included to the study. Mean age was $61.5{\pm}9.4$ years (range: 39-83 years). There was advanced disease in 86% (n=43) and the histological type was epithelial mesothelioma in the majority (82%). Of the cases, 17 (34%) received radiotherapy, while 42 cases underwent first- and second-line chemotherapy, with cisplatin plus pemetrexed as the most commonly used regimen. In the assessment after therapy, it was found that there was complete response in 4 cases (8%), partial response in 10 cases (20%), stable disease in 17 cases (34%) and progression in 19 cases (38%). Median follow-up was 10 months (range: 10 day-30 months). Median overall survival was found to be 20.7 months while median progression-free survival as 10 months. In univariate and multivariate analyses, it was found that factors significantly affecting overall survival included stage (p=0.030), response to treatment (p=0.026) and monocyte count (p=0.004), while factors affecting disease-free survival included NLR (p=0.018), response to treatment (p=0.001), and PLR score (p=0.003). Conclusions: Overall and disease-free survival was found to be better in cases with a WBC count<8.000, platelet count<300,000, and low NLR and PLR scores in malignant pleural mesothelioma.

References

  1. Suzuki K, Aiura K, Kitagou M, et al (2004). Platelets counts closely correlate with the disease-free survival interval of pancreatic cancer patients. Hepatogastroenterology, 51, 847-53.
  2. Schmidt H, Bastholt L, Geertsen P, et al (2005). Elevated neutrophil and monocyte counts in peripheral blood are associated with poor survival in patients with metastatic melanoma: a prognostic model. Br J Cancer, 93, 273-8. https://doi.org/10.1038/sj.bjc.6602702
  3. Smith RA, Bosonnet L, Raraty M, et al (2009). Preoperative platelet-lymphocyte ratio is an independent significant prognostic marker in resected pancreatic ductal adenocarcinoma. Am J Surg, 197, 466-70. https://doi.org/10.1016/j.amjsurg.2007.12.057
  4. Stahel RA, Weder W, Lievens Y, Felip E, ESMO Guidelines Working Group (2010). Malignant pleural mesothelioma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol, 21, 126-8. https://doi.org/10.1093/annonc/mdp271
  5. Utkan G, Urun Y, Cangir AK, et al (2013). Clinicopathological features of patients with malignant mesothelioma in a multicenter, case-control study: no role for ABO-Rh blood groups. Asian Pac J Cancer Prev, 14, 249-53. https://doi.org/10.7314/APJCP.2013.14.1.249
  6. Yamanaka T, Matsumoto S, Teramukai S, et al (2007). The baseline ratio of neutrophils to lymphocytes is associated with patient prognosis in advanced gastric cancer. Oncology, 73, 215-20. https://doi.org/10.1159/000127412
  7. Wang D, Yang JX, Cao DY, et al (2013). Preoperative neutrophillymphocyte and platelet-lymphocyte ratios as independent predictors of cervical stromal involvement in surgically treated endometrioid adenocarcinoma. Onco Targets Ther, 6, 211-6.
  8. Kishi Y, Kopetz S, Chun YS, et al (2009). Blood neutrophil-tolymphocyte ratio predicts survival in patients with colorectal liver metastases treated with systemic chemotherapy. Ann Surg Oncol, 16, 614-22. https://doi.org/10.1245/s10434-008-0267-6
  9. Cihan YB, Arslan A, Ergul MA (2013). Subtypes of white blood cells and among patients with prostate cancer, benign prostatic hyperplasia and healthy individuals. Asian Pac J Cancer Prev, 14, 4373-7. https://doi.org/10.7314/APJCP.2013.14.7.4373
  10. Edwards JG, Abrams KR, Leverment JN, et al (2000). Prognostic factors for malignant mesothelioma in 142 patients: validation of CALGB and EORTC prognostic scoring systems. Thorax, 55, 731-5. https://doi.org/10.1136/thorax.55.9.731
  11. Ibrahim Noha, Abou-Elela E, Darwish D (2013). Survival of mesothelioma in a palliative medical care unit in Egypt. Asian Pac J Cancer Prev, 14, 739-42. https://doi.org/10.7314/APJCP.2013.14.2.739
  12. Klinger MH, Jelkmann W (2002). Role of blood platelets in infection and inflammation. J Interferon Cytokine Res, 22, 913-22. https://doi.org/10.1089/10799900260286623
  13. Kwon HC, Kim SH, Oh SY, et al (2012). Clinical significance of preoperative neutrophil-lymphocyte versus plateletlymphocyte ratio in patients with operable colorectal cancer. Biomarkers, 17, 216-22. https://doi.org/10.3109/1354750X.2012.656705
  14. Li Q, Lu ZH, Yang L, et al (2014). Neutrophil count and the inflammation-based glasgow prognostic score predict survival in patients with advanced gastric cancer receiving first-line chemotherapy. Asian Pac J Cancer Prev, 15, 945-50. https://doi.org/10.7314/APJCP.2014.15.2.945
  15. Prete A, Allavena P, Santoro G, et al (2011). Molecular pathways in cancer-related inflammation. Biochem Med (Zagreb), 21, 264-75.
  16. Sarraf KM, Belcher E, Raevsky E, et al (2009). Neutrophil/lymphocyte ratio and its association with survival after complete resection in non-small cell lung cancer. J Thorac Cardiovasc Surg, 137, 425-8. https://doi.org/10.1016/j.jtcvs.2008.05.046
  17. Alexandrakis MG, Passam FH, Moschandrea IA, et al (2003). Levels of serum cytokines and acute phase proteins in patients with essential and cancer-related thrombocytosis. Am J Clin Oncol, 26, 135-140. https://doi.org/10.1097/00000421-200304000-00007
  18. Berk S, Dogan OT, Kilickap S, et al (2013). Clinical characteristics, treatment and survival outcomes in malignant mesothelioma: Eighteen years' experience in Turkey. Asian Pac J Cancer Prev, 13, 5735-9. https://doi.org/10.7314/APJCP.2012.13.11.5735
  19. Cedres S, Torrejon D, Martinez A, et al (2012). Neutrophil to lymphocyte ratio (NLR) as an indicator of poor prognosis in stage IV non-small cell lung cancer. Clin Transl Oncol, 14, 864-9. https://doi.org/10.1007/s12094-012-0872-5
  20. Chua W, Charles KA, Baracos VE, Clarke SJ (2011). Neutrophil/lymphocyte ratio predicts chemotherapy outcomes in patients with advanced colorectal cancer. Br J Cancer, 104, 1288-95. https://doi.org/10.1038/bjc.2011.100

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