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Published in: Updates in Surgery 4/2021

01-08-2021 | NSCLC | Original Article

Dynamic perioperative variation of neutrophil-to-lymphocyte ratio as an independent prognosis factor following lobectomy for NSCLC

Authors: Raices Micaela, Caram Lucas, Corvatta Franco, Cayol Federico, Dietrich Agustín, Smith David

Published in: Updates in Surgery | Issue 4/2021

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Abstract

Inflammation plays a key role in malignant tumor progression. The neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation and, as such, high isolated pretreatment NLR has been shown to be associated with worse long-term outcomes. The aim of the present study is to evaluate the prognostic value of pre- and post-operative NLR in relation to mortality and recurrence rates in patients undergoing lung lobectomy for NSCLC. A single-center retrospective analysis of 534 lobectomies was performed between 2009 and 2018. NLR was measured in two opportunities: 1 month prior to surgery and 1–4 months after. Primary outcomes were overall survival (OS) and recurrence-free survival (RFS). Secondary outcomes were variables associated with mortality and recurrence. The study sample included 264 lobectomies. Independent predictors of OS were ASA 3/4 (p = 0.041) and open surgical approach (p = 0.042). Adjuvant chemotherapy (p = 0.002) and pathological N 1/2-stage (p = 0.0015) were associated with RFS. Delta NLR correlated with OS (p = 0.042) and RFS (p < 0.001). Patients were divided into three delta NLR categories: delta NLR < 0, delta NLR 0–0.5 and delta NLR > 0.5. Increasing delta NLR was significantly associated with worse OS (p < 0.001) and RFS (p < 0.001). Dynamic behaviour of NLR assessed through delta NLR is a useful tool that potentially allows predicting mortality and recurrence outcomes in patients undergoing lung lobectomy for NSCLC and may be more informative than static baseline values.
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Metadata
Title
Dynamic perioperative variation of neutrophil-to-lymphocyte ratio as an independent prognosis factor following lobectomy for NSCLC
Authors
Raices Micaela
Caram Lucas
Corvatta Franco
Cayol Federico
Dietrich Agustín
Smith David
Publication date
01-08-2021
Publisher
Springer International Publishing
Published in
Updates in Surgery / Issue 4/2021
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI
https://doi.org/10.1007/s13304-020-00936-x

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