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Open Access 01-04-2020 | Melanoma | Original Article

The neutrophil–lymphocyte ratio and locoregional melanoma: a multicentre cohort study

Authors: Alyss V. Robinson, Claire Keeble, Michelle C. I. Lo, Owen Thornton, Howard Peach, Marc D. S. Moncrieff, Donald J. Dewar, Ryckie G. Wade

Published in: Cancer Immunology, Immunotherapy | Issue 4/2020

Abstract

Objectives

The neutrophil–lymphocyte ratio (NLR) is an inflammatory biomarker which is useful in cancer prognostication. We aimed to investigate the differences in baseline NLR between patients with localised and metastatic cutaneous melanoma and how this biomarker changed over time with the recurrence of disease.

Methods

This multicentre cohort study describes patients treated for Stage I–III cutaneous melanoma over 10 years. The baseline NLR was measured immediately prior to surgery and again at the time of discharge or disease recurrence. The odds ratios (OR) for sentinel node involvement are estimated using mixed-effects logistic regression. The risk of recurrence is estimated using multivariable Cox regression.

Results

Overall 1489 individuals were included. The mean baseline NLR was higher in patients with palpable nodal disease compared to those with microscopic nodal or localised disease (2.8 versus 2.4 and 2.3, respectively; p < 0.001). A baseline NLR ≥ 2.3 was associated with 30% higher odds of microscopic metastatic melanoma in the sentinel lymph node [adjusted OR 1.3 (95% CI 1.3, 1.3)]. Following surgery, 253 patients (18.7%) developed recurrent melanoma during surveillance although there was no statistically significant association between the baseline NLR and the risk of recurrence [adjusted HR 0.9 (0.7, 1.1)].

Conclusion

The NLR is associated with the volume of melanoma at presentation and may predict occult sentinel lymph metastases. Further prospective work is required to investigate how NLR may be modelled against other clinicopathological variables to predict outcomes and to understand the temporal changes in NLR following surgery for melanoma.

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Title: The neutrophil–lymphocyte ratio and locoregional melanoma: a multicentre cohort study
Authors: Alyss V. Robinson
Claire Keeble
Michelle C. I. Lo
Owen Thornton
Howard Peach
Marc D. S. Moncrieff
Donald J. Dewar
Ryckie G. Wade
Publication date: 01-04-2020
Publisher: Springer Berlin Heidelberg
Keywords: Melanoma
Melanoma
Lymphadenectomy
Biomarkers
Published in: Cancer Immunology, Immunotherapy / Issue 4/2020
Print ISSN: 0340-7004
Electronic ISSN: 1432-0851
DOI: https://doi.org/10.1007/s00262-019-02478-7

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