High Blood Neutrophil-to-Lymphocyte Ratio Is an Indicator of Poor Prognosis in Malignant Mesothelioma Patients Undergoing Systemic Therapy

• DOI: 10.1158/1078-0432.ccr-10-2245
• Publication Date: 2010-10-19T04:14:58Z
• Authors: Steven C.H. Kao; Nick Pavlakis; Rozelle Harvie; Janette L. Vardy; Michael J. Boyer; Nico van Zandwijk; Stephen J. Clarke
• Keywords: White blood cell; Absolute neutrophil count

Asbestos-induced chronic inflammation is implicated in the pathogenesis of malignant mesothelioma (MM). We have investigated blood neutrophil-to-lymphocyte ratio (NLR), an index systemic inflammation, as a prognostic factor MM patients.Patients with who had therapy at participating institutes were studied. Potential factors such age, gender, performance status, histologic subtype, and baseline laboratory parameters, including NLR, analyzed. Overall survival from commencement was determined by Kaplan-Meier method. Multivariate analyses using Cox Regression model performed significant (P ≤ 0.05) to determine their independent effect.A total 173 patients undergoing 119 receiving first-line 54 second- or third-line included this retrospective evaluation. Forty-two percent elevated NLR baseline. The following variables predictive survival: female gender = 0.044), epithelioid subtype < 0.001), white cell count less than 8.3 × 10⁹/L 0.008), platelet 400 0.05), 5 0.001). After multivariate analysis, [hazard (HR) 2.0; 95% confidence interval (CI) 1.3-2.9; P 0.001], (HR 2.7; CI 1.8-3.9; 0.001) remained predictors. 1-year rate 60% versus 26%, whereas 2-year 34% 10% for greater, respectively. In separate chemotherapy-naive previously treated patient groups, predictor both groups.Our results indicate that therapy.