Top

BMC Cancer

Published in:

Open Access 01-12-2018 | Research article

An inflammation-related nomogram for predicting the survival of patients with non-small cell lung cancer after pulmonary lobectomy

Authors: Ying Wang, Xiao Qu, Ngar-Woon Kam, Kai Wang, Hongchang Shen, Qi Liu, Jiajun Du

Published in: BMC Cancer | Issue 1/2018

Abstract

Background

Emerging inflammatory response biomarkers are developed to predict the survival of patients with cancer, the aim of our study is to establish an inflammation-related nomogram based on the classical predictive biomarkers to predict the survivals of patients with non-small cell lung cancer (NSCLC).

Methods

Nine hundred and fifty-two NSCLC patients with lung cancer surgery performed were enrolled into this study. The cutoffs of inflammatory response biomarkers were determined by Receiver operating curve (ROC). Univariate and multivariate analysis were conducted to select independent prognostic factors to develop the nomogram.

Results

The median follow-up time was 40.0 months (range, 1 to 92 months). The neutrophil to lymphocyte ratio (cut-off: 3.10, HR:1.648, P = 0.045) was selected to establish the nomogram which could predict the 5-year OS probability. The C-index of nomogram was 0.72 and the 5-year OS calibration curve displayed an optimal agreement between the actual observed outcomes and the predictive results.

Conclusions

Neutrophil to lymphocyte ratio was shown to be a valuable biomarker for predicting survival of patients with NSCLC. The addition of neutrophil to lymphocyte ratio could improve the accuracy and predictability of the nomogram in order to provide reference for clinicians to assess patient outcomes.

Groome PA, Bolejack V, Crowley JJ, Kennedy C, Krasnik M, Sobin LH, Goldstraw P. The IASLC lung Cancer staging project: validation of the proposals for revision of the T, N, and M descriptors and consequent stage groupings in the forthcoming (seventh) edition of the TNM classification of malignant tumours. J Thorac Oncol. 2007;2(8):694–705.CrossRefPubMed

Shoenfeld Y, Tal A, Berliner S, Pinkhas J. Leukocytosis in non hematological malignancies--a possible tumor-associated marker. J Cancer Res Clin Oncol. 1986;111(1):54–8.CrossRefPubMed

Cannon NA, Meyer J, Iyengar P, Ahn C, Westover KD, Choy H, Timmerman R. Neutrophil-lymphocyte and platelet-lymphocyte ratios as prognostic factors after stereotactic radiation therapy for early-stage non-small-cell lung cancer. J Thorac Oncol. 2015;10(2):280–5.CrossRefPubMed

Choi JE, Villarreal J, Lasala J, Gottumukkala V, Mehran RJ, Rice D, Yu J, Feng L, Cata JP. Perioperative neutrophil:lymphocyte ratio and postoperative NSAID use as predictors of survival after lung cancer surgery: a retrospective study. Cancer Med. 2015;4(6):825–33.CrossRefPubMedPubMedCentral

Dirican A, Kucukzeybek BB, Alacacioglu A, Kucukzeybek Y, Erten C, Varol U, Somali I, Demir L, Bayoglu IV, Yildiz Y, et al. Do the derived neutrophil to lymphocyte ratio and the neutrophil to lymphocyte ratio predict prognosis in breast cancer? Int J Clin Oncol. 2015;20(1):70–81.CrossRefPubMed

Huang C, Yue J, Li Z, Li N, Zhao J, Qi D. Usefulness of the neutrophil-to-lymphocyte ratio in predicting lymph node metastasis in patients with non-small cell lung cancer. Tumour Biol. 2015;36(10):7581–9.CrossRefPubMed

Kemal Y, Yucel I, Ekiz K, Demirag G, Yilmaz B, Teker F, Ozdemir M. Elevated serum neutrophil to lymphocyte and platelet to lymphocyte ratios could be useful in lung cancer diagnosis. Asian Pac J Cancer Prev. 2014;15(6):2651–4.CrossRefPubMed

Lin GN, Peng JW, Liu PP, Liu DY, Xiao JJ, Chen XQ. Elevated neutrophil-to-lymphocyte ratio predicts poor outcome in patients with advanced non-small-cell lung cancer receiving first-line gefitinib or erlotinib treatment. Asia-Pacific journal of clinical oncology 2017;13(5):e189–e194.

Sarraf KM, Belcher E, Raevsky E, Nicholson AG, Goldstraw P, Lim E. Neutrophil/lymphocyte ratio and its association with survival after complete resection in non-small cell lung cancer. J Thorac Cardiovasc Surg. 2009;137(2):425–8.CrossRefPubMed

10.

Walsh SR, Cook EJ, Goulder F, Justin TA, Keeling NJ. Neutrophil-lymphocyte ratio as a prognostic factor in colorectal cancer. J Surg Oncol. 2005;91(3):181–4.CrossRefPubMed

11.

Absenger G, Szkandera J, Pichler M, Stotz M, Arminger F, Weissmueller M, Schaberl-Moser R, Samonigg H, Stojakovic T, Gerger A. A derived neutrophil to lymphocyte ratio predicts clinical outcome in stage II and III colon cancer patients. Br J Cancer. 2013;109(2):395–400.CrossRefPubMedPubMedCentral

12.

Szkandera J, Gerger A, Liegl-Atzwanger B, Stotz M, Samonigg H, Friesenbichler J, Stojakovic T, Leithner A, Pichler M. The derived neutrophil/lymphocyte ratio predicts poor clinical outcome in soft tissue sarcoma patients. Am J Surg. 2014;210(1):111–6.CrossRefPubMed

13.

Huang Y, Feng JF. Low preoperative lymphocyte to monocyte ratio predicts poor cancer-specific survival in patients with esophageal squamous cell carcinoma. OncoTargets Ther. 2015;8:137–45.

14.

Lin GN, Peng JW, Xiao JJ, Liu DY, Xia ZJ. Prognostic impact of circulating monocytes and lymphocyte-to-monocyte ratio on previously untreated metastatic non-small cell lung cancer patients receiving platinum-based doublet. Med Oncol. 2014;31(7):70.CrossRefPubMed

15.

Hu B, Yang XR, Xu Y, Sun YF, Sun C, Guo W, Zhang X, Wang WM, Qiu SJ, Zhou J, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res. 2014;20(23):6212–22.CrossRefPubMed

16.

Liang W, Zhang L, Jiang G, Wang Q, Liu L, Liu D, Wang Z, Zhu Z, Deng Q, Xiong X, et al. Development and validation of a nomogram for predicting survival in patients with resected non-small-cell lung cancer. J Clin Oncol. 2015;33(8):861–9.CrossRefPubMed

17.

Keam B, Kim DW, Park JH, Lee JO, Kim TM, Lee SH, Chung DH, Heo DS. Nomogram predicting clinical outcomes in non-small cell lung Cancer patients treated with epidermal growth factor receptor tyrosine kinase inhibitors. Cancer Res Treat. 2014;46(4):323–30.CrossRefPubMedPubMedCentral

18.

Hu P, Shen H, Wang G, Zhang P, Liu Q, Du J. Prognostic significance of systemic inflammation-based lymphocyte- monocyte ratio in patients with lung cancer: based on a large cohort study. PLoS One. 2014;9(9):e108062.CrossRefPubMedPubMedCentral

19.

Qu X, Pang Z, Yi W, Wang Y, Wang K, Liu Q, Du J. High percentage of alpha1-globulin in serum protein is associated with unfavorable prognosis in non-small cell lung cancer. Med Oncol. 2014;31(10):238.CrossRefPubMed

20.

Yuan D, Zhu K, Li K, Yan R, Jia Y, Dang C. The preoperative neutrophil-lymphocyte ratio predicts recurrence and survival among patients undergoing R0 resections of adenocarcinomas of the esophagogastric junction. J Surg Oncol. 2014;110(3):333–40.CrossRefPubMed

21.

Forget P, Machiels JP, Coulie PG, Berliere M, Poncelet AJ, Tombal B, Stainier A, Legrand C, Canon JL, Kremer Y, et al. Neutrophil:lymphocyte ratio and intraoperative use of ketorolac or diclofenac are prognostic factors in different cohorts of patients undergoing breast, lung, and kidney cancer surgery. Ann Surg Oncol. 2013;20(Suppl 3):S650–60.CrossRefPubMed

22.

Zhang S, Da L, Yang X, Feng D, Yin R, Li M, Zhang Z, Jiang F, Xu L. Celecoxib potentially inhibits metastasis of lung cancer promoted by surgery in mice, via suppression of the PGE2-modulated beta-catenin pathway. Toxicol Lett. 2014;225(2):201–7.CrossRefPubMed

23.

Kusumanto YH, Dam WA, Hospers GA, Meijer C, Mulder NH. Platelets and granulocytes, in particular the neutrophils, form important compartments for circulating vascular endothelial growth factor. Angiogenesis. 2003;6(4):283–7.CrossRefPubMed

24.

McGuire L, Kiecolt-Glaser JK, Glaser R. Depressive symptoms and lymphocyte proliferation in older adults. J Abnorm Psychol. 2002;111(1):192–7.CrossRefPubMed

Title: An inflammation-related nomogram for predicting the survival of patients with non-small cell lung cancer after pulmonary lobectomy
Authors: Ying Wang
Xiao Qu
Ngar-Woon Kam
Kai Wang
Hongchang Shen
Qi Liu
Jiajun Du
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Cancer / Issue 1/2018
Electronic ISSN: 1471-2407
DOI: https://doi.org/10.1186/s12885-018-4513-4

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2018

Re-challenging immune checkpoint inhibitor in a patient with advanced non-small cell lung cancer: a case report

Generation and characterization of MEK and ERK inhibitors- resistant non-small-cells-lung-cancer (NSCLC) cells

One-year mortality and Periprosthetic infection rates after Total knee Arthroplasty in Cancer patients: a population-based cohort study

Colon cancer patients with a serious psychiatric disorder present with a more advanced cancer stage and receive less adjuvant chemotherapy - A Nationwide Danish Cohort Study

MALBAC-based chromosomal imbalance analysis: a novel technique enabling effective non-invasive diagnosis and monitoring of bladder cancer

Genomic analysis of DNA repair genes and androgen signaling in prostate cancer

Keynote webinar | Spotlight on antibody–drug conjugates in cancer