Prognostic utility of the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio for cancer patients with brain metastasis
Main Article Content
Abstract
This study aims to determine the utility of the neutrophil-to-lymphocyte-ratio (NLR) and platelet-to-lymphocyte-ratio (PLR) as prognostic markers for brain metastasis (BM). Employing NLR cutoff values at BM diagnosis, 550 patients were divided into groups I-III (I:<3, II: 3–4.49, III: >4.5), and median overall survival (MOS) was calculated (I: 20 months, II: 13.9 months, and III: 7.5 months). Groups divided by a PLR cutoff (I:250, II:≥250 also differed in MOS (13.9 vs. 9.3 months). After multivariable analysis, only NLR was a significant independent predictor of MOS [I vs. II: 1.5 Hazard Ratio (HR); I vs. III: 1.9 HR].
Keywords:
survival, prognosis, platelet-to-lymphocyte ratio, brain metastasis
Article Details
How to Cite
CACHO-DÍAZ, Bernardo et al.
Prognostic utility of the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio for cancer patients with brain metastasis.
Medical Research Archives, [S.l.], v. 8, n. 5, may 2020.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/2092>. Date accessed: 23 apr. 2024.
doi: https://doi.org/10.18103/mra.v8i5.2092.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
1. McFaline-Figueroa JR, Lee EQ. Brain Tumors. The American Journal of Medicine. 131(8):874-882. 2018. Doi: 10.1016/j.amjmed.2017.12.039
2. Nayak L, Lee EQ, Wen PY. Epidemiology of Brain Metastases. Curr Oncol Rep, 2012. 14:48–54. Doi: 10.1007/s11912-011-0203-y.
3. Ostrom QT, Wright CH, Barnholtz-Sloan JS. Brain metastases: epidemiology. The Handbook of Clinical Neurology, 2018. 149:27.42. Doi: 10.1016/B978-0-12-811161-1.00002-5.
4. Cacho-Díaz B, Spinola-Maroño H, González-Aguilar A, et al. Factors associated with long-term survival in central nervous system metastases. Journal of Neuro-Oncology, 2018. 140(1):159-164. Doi: 10.1007/s11060-018-2946-x.
5. Barnholtz-Sloan JS, Yu C, Sloan AE, et al. A nomogram for individualized estimation of survival among patients with brain metastasis. Neuro Oncol, 2012. 14:910–918. Doi: 10.1093/neuonc/nos087
6. Venur VA, Ahluwalia MS. Prognostic scores for brain metastasis patients: use in clinical practice and trial design. Chinese Clin Oncol, 2015; 4. Doi: 10.3978/j.issn.2304-3865.2015.06.01.
7. Hanahan D, Weinberg RA. Hallmarks of cancer. Cell, 2000. 100(1):57-70. Doi: 10.1016/s0092-8674(00)81683-9
8. McMillan DC. The systemic inflammation-based Glasgow Prognostic Score: A decade of experience in patients with cancer. Cancer Treatment Reviews, 2013 39:534-540. Doi: 10.1016/j.ctrv.2012.08.003.
9. Walsh SR, Cook EJ, Goulder F, et al. Neutrophil–lymphocyte ratio as a prognostic factor in colorectal cancer. Journal of Surgical Oncology, 2005. 91(3):181–4. Doi: 10.1002/jso.20329
10. Takenaka Y, Oya R, Kitamiura T, et al. Prognostic role of neutrophil-to-lymphocyte ratio in head and neck cancer: A meta-analysis. Head & Neck, 2017; 40:647-655. Doi: 10.1002/hed.24986
11. Pillay J, Pickkers P, Koenderman L, et al. A subset of neutrophils in human systemic inflammation inhibits T cell responses through Mac-1. The Journal of Clinical Investigation, 2012; 122(1):327-336. Doi: 10.1172/JCI57990
12. Mei Z, Shi L, Wang B, et al. Prognostic role of pretreatment blood neutrophil-to-lymphocyte ratio in advanced cancer survivors: A systematic review and meta-analysis of 66 cohort studies. Cancer Treatment Reviews, 2017; 58:1-13. Doi: 10.1016/j.ctrv.2017.05.005
13. Cukic V. Neutrophil/Lymphocyte Ratio and Platelet/Lymphocyte Ratio in Patients with NSCLC. Mater Sociomed, 2016; 28(5):378-381. Doi: 10.5455/msm.2016.28.378-381
14. Auezova R, Ryskeldiev N, Doskaliyev A, et al. Association of preoperative levels of selected blood inflammatory markers with prognosis in gliomas. OncoTargets and Therapy, 2016; 9:6111-6117. Doi: 10.2147/OTT.S113606
15. Lou M, Luo P, Tang R, et al. Relationship between neutrophil-lymphocyte ratio and insulin resistance in newly diagnosed type 2 diabetes mellitus patients. BMC Endocrine Disorders, 2015; 15:9. Doi: 10.1186/s12902-015-0002-9
16. Rembach A, Watt AD, Wilson WJ, et al. An increased neutrophil-lymphocyte ratio in Alzheimer's disease is a function of age and is weakly correlated with neocortical amyloid accumulation. Journal of Neuroimmunology, 2014. 273:65-71. Doi: 10.1016/j.jneuroim.2014.05.005
17. Tamhane UU, Aneja S, Montgomery D, et al. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol, 2008. 102:653-657. Doi: 10.1016/j.amjcard.2008.05.006
18. Azab B, Jaglall N, Atallah JP, et al. Neutrophil-Lymphocyte Ratio as a predictor of adverse outcomes of acute pancreatitis. Pancreatology, 2011; 11:445-452. Doi: 10.1159/000331494
19. Kurtul A, Murat SN, Yarlioglues M, et al. Association of Platelet-to-Lymphocyte Rratio with severity and complexity of coronary artery disease in patients with Acute coronary syndromes. Am J Cardiol, 2014; 114:972-978. Doi: 10.1016/j.amjcard.2014.07.005.
20. Turkmen K, Erdur FM, Ozcicek F, et al. Platelet-to-Lymphocyte Ratio better predicts inflammation than neutrophil-to-lymphocyte ratio in end-stage renal disease patients. Hemodialysis International, 2013; 17:319-393. Doi: 10.1111/hdi.12040
21. Chowdhary M, Switchenko JM, Press RH, et al. Post-treatment neutrophil-to-lymphocyte ratio predicts for overall survival in brain metastases treated with stereotactic radiosurgery. Journal of Neuro-Oncology, 2018; 139:689-697. Doi: 0.1007/s11060-018-2914-5
22. Wang J, Xiao W, Chen W, et al. Prognostic significance of preoperative neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in patients with glioma. EXCLI Journal, 2018; 17:505-512. Doi: 10.17179/excli2017-978
23. Mitsuya K, Nakasu Y, Kurakane T, et al. Elevated preoperative neutrophil-to-lymphocyte ratio as a predictor of worse survival after resection in patients with brain metastases. J Neurosurg, 2017; 127:433-437. Doi: 10.3171/2016.8.JNS16899
24. Chowdhary M, Switchenko J, Marwaha G, et al. Post-treatment Neutrophil-to-Lymphocyte ratio as a predictor of overall survival in melanoma brain metastases treated with stereotactic radiosurgery. International Journal of Radiation Oncology Biology Physics, 2017; 99(2)1;S169. Doi: 10.1016/j.ijrobp.2017.06.428
25. Guthrie GJK, Charles KA, Roxburgh CSD, et al. The systemic inflammation-based neutrophil-to-lymphocyte ratio: Experience in patients with cancer. Critical Reviews in Oncology/Hematology, 2013; 88:218-230. Doi: 10.1016/j.critrevonc.2013.03.010.
26. Templeton AJ, McNamara MG, Seruga B, et al. Prognostic Role of Neutrophil-to-Lymphocyte Ratio in solid tumors: A systematic review and Meta-Analysis. J Natl Cancer Inst, 2014; 106(6):124. Doi: 10.1093/jnci/dju124
27. Zhao QT, Yang Y, Xu S, et al. Prognostic role of neutrophil to lymphocyte ratio in lung cancers: a meta-analysis including 7,054 patients. OncoTargets and Therapy, 2015; 8:2731-2738. Doi: 10.2147/OTT.S90875
28. Dolan RD, McSorley ST, Horgan PG, et al. The role of the systemic inflammatory response in predicting outcomes in patients with advanced inoperable cancer: Systematic review and meta-analysis. Crit Rev Oncol Hematol, 2017; 116:134-146. Doi: 10.1016/j.critrevonc.2017.06.002
29. Paramanathan A, Saxena A, Morris DL. A systematic review and meta-analysis on the impact of pre-operative neutrophil lymphocyte ratio on long term outcomes after curative intent resection of solid tumours. Surgical Oncology, 2014; 23:31-39. Doi: 10.1016/j.suronc.2013.12.001
30. Ethier JL, Desautels DN, Templeton AJ, et al. Is the neutrophil-to-lymphocyte ratio prognostic of survival outcomes in gynecologic cancers? A systematic review and meta-analysis. Gynecologic Oncology, 2017; 145:584-594. Doi: 10.1016/j.ygyno.2017.02.026
31. Marchioni M, Primiceri G, Ingrosso M, et al. The Clinical Use of the Neutrophil to Lymphocyte Ratio (NLR) in Urothelial Cancer: A Systematic Review. Clinical Genitourinary Cancer, 2016; 14(6):473-84. Doi: 10.1016/j.clgc.2016.04.008.
32. Koh YW, Choi J., Ahn MS, et al. Baseline neutrophil–lymphocyte ratio is associated with baseline and subsequent presence of brain metastases in advanced non-small cell lung cancer. Sci Rep, 2016; 6: 38585. Doi: 10.1038/srep38585
33. Doi H, Nakamatsu K, Anami S, et al. Neutrophil–to–Lymphocyte Ratio Predicts Survival After Whole-brain Radiotherapy in Non-small Cell Lung Cancer. In vivo, 2019; 33: 195-201. Doi: 10.21873/invivo.11459
34. Tian C, Song W, Tian X, et al. Prognostic significance of platelet-to-lymphocyte ratio in patients with ovarian cancer: A meta-analysis. Eur J Clin Invest, 2018; 48(5):e12917. Doi: 10.21873/invivo.11459
35. Li B, Zhoub P, Liu, et al. Platelet-to-lymphocyte ratio in advanced Cancer: Review and meta-analysis. Clínica Chimica Acta, 2018; 483:48-56. Doi: 10.1016/j.cca.2018.04.023
36. Templeton AJ, Ace O, McNamara MG, et al. Prognostic Role of Platelet to Lymphocyte Ratio in solid tumors: A systematic review and Meta-Analysis. Cancer Epidemiol Biomarkers Prev, 2014; 23(7):1-9. Doi: 10.1158/1055-9965.EPI-14-0146
2. Nayak L, Lee EQ, Wen PY. Epidemiology of Brain Metastases. Curr Oncol Rep, 2012. 14:48–54. Doi: 10.1007/s11912-011-0203-y.
3. Ostrom QT, Wright CH, Barnholtz-Sloan JS. Brain metastases: epidemiology. The Handbook of Clinical Neurology, 2018. 149:27.42. Doi: 10.1016/B978-0-12-811161-1.00002-5.
4. Cacho-Díaz B, Spinola-Maroño H, González-Aguilar A, et al. Factors associated with long-term survival in central nervous system metastases. Journal of Neuro-Oncology, 2018. 140(1):159-164. Doi: 10.1007/s11060-018-2946-x.
5. Barnholtz-Sloan JS, Yu C, Sloan AE, et al. A nomogram for individualized estimation of survival among patients with brain metastasis. Neuro Oncol, 2012. 14:910–918. Doi: 10.1093/neuonc/nos087
6. Venur VA, Ahluwalia MS. Prognostic scores for brain metastasis patients: use in clinical practice and trial design. Chinese Clin Oncol, 2015; 4. Doi: 10.3978/j.issn.2304-3865.2015.06.01.
7. Hanahan D, Weinberg RA. Hallmarks of cancer. Cell, 2000. 100(1):57-70. Doi: 10.1016/s0092-8674(00)81683-9
8. McMillan DC. The systemic inflammation-based Glasgow Prognostic Score: A decade of experience in patients with cancer. Cancer Treatment Reviews, 2013 39:534-540. Doi: 10.1016/j.ctrv.2012.08.003.
9. Walsh SR, Cook EJ, Goulder F, et al. Neutrophil–lymphocyte ratio as a prognostic factor in colorectal cancer. Journal of Surgical Oncology, 2005. 91(3):181–4. Doi: 10.1002/jso.20329
10. Takenaka Y, Oya R, Kitamiura T, et al. Prognostic role of neutrophil-to-lymphocyte ratio in head and neck cancer: A meta-analysis. Head & Neck, 2017; 40:647-655. Doi: 10.1002/hed.24986
11. Pillay J, Pickkers P, Koenderman L, et al. A subset of neutrophils in human systemic inflammation inhibits T cell responses through Mac-1. The Journal of Clinical Investigation, 2012; 122(1):327-336. Doi: 10.1172/JCI57990
12. Mei Z, Shi L, Wang B, et al. Prognostic role of pretreatment blood neutrophil-to-lymphocyte ratio in advanced cancer survivors: A systematic review and meta-analysis of 66 cohort studies. Cancer Treatment Reviews, 2017; 58:1-13. Doi: 10.1016/j.ctrv.2017.05.005
13. Cukic V. Neutrophil/Lymphocyte Ratio and Platelet/Lymphocyte Ratio in Patients with NSCLC. Mater Sociomed, 2016; 28(5):378-381. Doi: 10.5455/msm.2016.28.378-381
14. Auezova R, Ryskeldiev N, Doskaliyev A, et al. Association of preoperative levels of selected blood inflammatory markers with prognosis in gliomas. OncoTargets and Therapy, 2016; 9:6111-6117. Doi: 10.2147/OTT.S113606
15. Lou M, Luo P, Tang R, et al. Relationship between neutrophil-lymphocyte ratio and insulin resistance in newly diagnosed type 2 diabetes mellitus patients. BMC Endocrine Disorders, 2015; 15:9. Doi: 10.1186/s12902-015-0002-9
16. Rembach A, Watt AD, Wilson WJ, et al. An increased neutrophil-lymphocyte ratio in Alzheimer's disease is a function of age and is weakly correlated with neocortical amyloid accumulation. Journal of Neuroimmunology, 2014. 273:65-71. Doi: 10.1016/j.jneuroim.2014.05.005
17. Tamhane UU, Aneja S, Montgomery D, et al. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol, 2008. 102:653-657. Doi: 10.1016/j.amjcard.2008.05.006
18. Azab B, Jaglall N, Atallah JP, et al. Neutrophil-Lymphocyte Ratio as a predictor of adverse outcomes of acute pancreatitis. Pancreatology, 2011; 11:445-452. Doi: 10.1159/000331494
19. Kurtul A, Murat SN, Yarlioglues M, et al. Association of Platelet-to-Lymphocyte Rratio with severity and complexity of coronary artery disease in patients with Acute coronary syndromes. Am J Cardiol, 2014; 114:972-978. Doi: 10.1016/j.amjcard.2014.07.005.
20. Turkmen K, Erdur FM, Ozcicek F, et al. Platelet-to-Lymphocyte Ratio better predicts inflammation than neutrophil-to-lymphocyte ratio in end-stage renal disease patients. Hemodialysis International, 2013; 17:319-393. Doi: 10.1111/hdi.12040
21. Chowdhary M, Switchenko JM, Press RH, et al. Post-treatment neutrophil-to-lymphocyte ratio predicts for overall survival in brain metastases treated with stereotactic radiosurgery. Journal of Neuro-Oncology, 2018; 139:689-697. Doi: 0.1007/s11060-018-2914-5
22. Wang J, Xiao W, Chen W, et al. Prognostic significance of preoperative neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in patients with glioma. EXCLI Journal, 2018; 17:505-512. Doi: 10.17179/excli2017-978
23. Mitsuya K, Nakasu Y, Kurakane T, et al. Elevated preoperative neutrophil-to-lymphocyte ratio as a predictor of worse survival after resection in patients with brain metastases. J Neurosurg, 2017; 127:433-437. Doi: 10.3171/2016.8.JNS16899
24. Chowdhary M, Switchenko J, Marwaha G, et al. Post-treatment Neutrophil-to-Lymphocyte ratio as a predictor of overall survival in melanoma brain metastases treated with stereotactic radiosurgery. International Journal of Radiation Oncology Biology Physics, 2017; 99(2)1;S169. Doi: 10.1016/j.ijrobp.2017.06.428
25. Guthrie GJK, Charles KA, Roxburgh CSD, et al. The systemic inflammation-based neutrophil-to-lymphocyte ratio: Experience in patients with cancer. Critical Reviews in Oncology/Hematology, 2013; 88:218-230. Doi: 10.1016/j.critrevonc.2013.03.010.
26. Templeton AJ, McNamara MG, Seruga B, et al. Prognostic Role of Neutrophil-to-Lymphocyte Ratio in solid tumors: A systematic review and Meta-Analysis. J Natl Cancer Inst, 2014; 106(6):124. Doi: 10.1093/jnci/dju124
27. Zhao QT, Yang Y, Xu S, et al. Prognostic role of neutrophil to lymphocyte ratio in lung cancers: a meta-analysis including 7,054 patients. OncoTargets and Therapy, 2015; 8:2731-2738. Doi: 10.2147/OTT.S90875
28. Dolan RD, McSorley ST, Horgan PG, et al. The role of the systemic inflammatory response in predicting outcomes in patients with advanced inoperable cancer: Systematic review and meta-analysis. Crit Rev Oncol Hematol, 2017; 116:134-146. Doi: 10.1016/j.critrevonc.2017.06.002
29. Paramanathan A, Saxena A, Morris DL. A systematic review and meta-analysis on the impact of pre-operative neutrophil lymphocyte ratio on long term outcomes after curative intent resection of solid tumours. Surgical Oncology, 2014; 23:31-39. Doi: 10.1016/j.suronc.2013.12.001
30. Ethier JL, Desautels DN, Templeton AJ, et al. Is the neutrophil-to-lymphocyte ratio prognostic of survival outcomes in gynecologic cancers? A systematic review and meta-analysis. Gynecologic Oncology, 2017; 145:584-594. Doi: 10.1016/j.ygyno.2017.02.026
31. Marchioni M, Primiceri G, Ingrosso M, et al. The Clinical Use of the Neutrophil to Lymphocyte Ratio (NLR) in Urothelial Cancer: A Systematic Review. Clinical Genitourinary Cancer, 2016; 14(6):473-84. Doi: 10.1016/j.clgc.2016.04.008.
32. Koh YW, Choi J., Ahn MS, et al. Baseline neutrophil–lymphocyte ratio is associated with baseline and subsequent presence of brain metastases in advanced non-small cell lung cancer. Sci Rep, 2016; 6: 38585. Doi: 10.1038/srep38585
33. Doi H, Nakamatsu K, Anami S, et al. Neutrophil–to–Lymphocyte Ratio Predicts Survival After Whole-brain Radiotherapy in Non-small Cell Lung Cancer. In vivo, 2019; 33: 195-201. Doi: 10.21873/invivo.11459
34. Tian C, Song W, Tian X, et al. Prognostic significance of platelet-to-lymphocyte ratio in patients with ovarian cancer: A meta-analysis. Eur J Clin Invest, 2018; 48(5):e12917. Doi: 10.21873/invivo.11459
35. Li B, Zhoub P, Liu, et al. Platelet-to-lymphocyte ratio in advanced Cancer: Review and meta-analysis. Clínica Chimica Acta, 2018; 483:48-56. Doi: 10.1016/j.cca.2018.04.023
36. Templeton AJ, Ace O, McNamara MG, et al. Prognostic Role of Platelet to Lymphocyte Ratio in solid tumors: A systematic review and Meta-Analysis. Cancer Epidemiol Biomarkers Prev, 2014; 23(7):1-9. Doi: 10.1158/1055-9965.EPI-14-0146