| Affiliation: | 1. Lineberger Comprehensive Cancer Center, and University of North Carolina at Chapel Hill, Chapel Hill, North, Carolina, USA;2. Department of Medicine, Division of Hematology/Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North, Carolina, USA;3. Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North, Carolina, USA. |
| Abstract: | BackgroundOur aim was to evaluate the prognostic impact of three inflammatory markers - neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR) and lymphocyte monocyte ratio (LMR) - on overall survival (OS) in older adults with cancer.Materials and MethodsOur sample includes 144 patients age?≥?65?years with solid tumor cancer who completed a cancer-specific Geriatric Assessment (GA) from 2010 to 2014 and had pretreatment CBC with differential. NLR was dichotomized a previously reported cut-off value of 3.5, while PLR and LMR were dichotomized at the median. Cox proportional hazards models evaluated whether NLR, PLR and LMR were predictive of OS independent of covariates including a recently developed 3-item GA-derived prognostic scale consisting of (1) “limitation in walking several blocks”, (2) “limitation in shopping”, and (3) “≥ 5% unintentional weight loss in 6 months”.ResultsMedian age was 72?years, 53% had breast cancer, 27% had stage 4 cancer, 14% had Karnofsky Performance Status (KPS)??3.5. In univariable analysis, higher NLR and PLR and lower LMR were significantly associated with worse OS. NLR remained a significant predictor of OS (HR?=?2.16, 95% CI; 1.10–4.25, p?=?.025) after adjusting for cancer type, stage, age, KPS, treatment intensity, and the GA-derived prognostic scale.ConclusionNLR?>?3.5 is predictive of poorer OS in older adults with cancer, independent of traditional prognostic factors and the GA-derived prognostic scale. |
