Pretreatment neutrophil count as an independent prognostic factor in advanced non-small-cell lung cancer: An analysis of Japan Multinational Trial Organisation LC00-03 |
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| Authors: | Satoshi Teramukai Toshiyuki Kitano Yusuke Kishida Masaaki Kawahara Kaoru Kubota Kiyoshi Komuta Koichi Minato Tadashi Mio Yuka Fujita Toshiro Yonei Kikuo Nakano Masahiro Tsuboi Kazuhiko Shibata Kiyoyuki Furuse Masanori Fukushima |
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| Institution: | 1. Department of Medical Oncology, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing;2. Department of Pulmonology, Shanghai Chest Hospital, Shanghai;3. Department of Oncology, The First Hospital Affiliated to Jilin University, Changchun;4. Department of Lung Cancer Medical Oncology, Sichuan Cancer Hospital, Chengdu;5. Department of Medical Oncology, The First Hospital of China Medical University, Shenyang;6. Department of Respiratory Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang;7. Department of Respiratory Medicine, Shanxi Provincial Tumor Hospital, Taiyuan;8. Department of Oncology, Henan Cancer Hospital, Zhengzhou;9. Department of Respiratory Medicine, Xijing Hospital, The Fourth Military Medical University, Xi’an;10. Department of Oncology, Jiangsu Cancer Hospital, Nanjing;11. Department of Oncology, Tangdu Hospital, The Fourth Military Medical University, Xi’an;12. Department of Medical Oncology, The Affiliated Tumor Hospital of Harbin Medical University, Harbin;13. Department of Imaging Diagnosis, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing;14. Department of Biostatistics, Peking University Clinical Research Institute, Beijing;15. Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing;16. Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University, Beijing;17. Department of Radiology, Peking Union Medical College Hospital, Beijing;18. Department of Pulmonary Oncology, The 307th Hospital of Chinese People’s Liberation Army, Beijing;19. Department of Medical Oncology, Cancer Hospital of Shantou University Medical College, Shantou;20. Department of Respiratory Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang;21. Department of Thoracic Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin;22. Department of Oncology, Jiangsu Provincial Hospital, Nanjing;23. Betta Pharmaceuticals Co., Ltd, Hangzhou, China |
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| Abstract: | We examined the impact of pretreatment neutrophil count on survival in patients with advanced non-small-cell lung cancer (NSCLC). A total of 388 chemo-naïve patients with stage IIIB or IV NSCLC from a randomised controlled trial were evaluated. The effects of pretreatment peripheral blood neutrophil, lymphocyte and monocyte counts and neutrophil–lymphocyte ratio on survival were examined using the proportional hazards regression model to estimate hazard ratios after adjustment for covariates. The optimal cut-off value was determined by proportional hazards regression analysis with the minimum P-value approach and shrinkage procedure. After adjustment for prognostic factors, the pretreatment elevated neutrophil count was statistically significantly associated with short overall (P = 0.0008) and progression-free survival (P = 0.024), whereas no association was found between prognosis and lymphocyte or monocyte count. The cut-off value selected for neutrophil count was 4500 mm–3 (corrected hazard ratio, 1.67; 95% confidence interval (CI), 1.09–2.54). The median survival time was 19.3 months (95%CI, 16.5–21.4) for the low-neutrophil group (?4500 mm–3, n = 204) and was 10.2 months (95%CI, 8.0–12.3) for the high-neutrophil group (?4500 mm–3, n = 184). We confirmed that pretreatment elevated neutrophil count is an independent prognostic factor in patients with advanced NSCLC receiving modern chemotherapy. Neutrophil count is easily measured at low cost, and it may be a useful indicator of patient prognosis. |
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