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Neutrophil‐lymphocyte and platelet‐lymphocyte ratio as predictors of disease specific survival after resection of adrenocortical carcinoma
Author(s) -
Bagante Fabio,
Tran Thuy B.,
Postlewait Lauren M.,
Maithel Shishir K.,
Wang Tracy S.,
Evans Douglas B.,
Hatzaras Ioannis,
Shenoy Rivfka,
Phay John E.,
Keplinger Kara,
Fields Ryan C.,
Jin Linda X.,
Weber Sharon M.,
Salem Ahmed,
Sicklick Jason K.,
Gad Shady,
Yopp Adam C.,
Mansour John C.,
Duh QuanYang,
Seiser Natalie,
Solorzano Carmen C.,
Kiernan Colleen M.,
Votanopoulos Konstantinos I.,
Levine Edward A.,
Poultsides George A.,
Pawlik Timothy M.
Publication year - 2015
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23982
Subject(s) - medicine , adrenocortical carcinoma , neutrophil to lymphocyte ratio , lymphocyte , gastroenterology , multivariate analysis , platelet , carcinoma , immune system , immunology
Background The systemic inflammatory response may be associated with tumor progression. We sought to analyze the impact of neutrophil‐lymphocyte ratio (NLR) and platelet‐lymphocyte ratio (PLR) on recurrence‐free survival (RFS) and disease‐specific survival (DSS) among patients who underwent surgery for adrenocortical carcinoma (ACC). Methods Patients undergoing surgery for ACC were identified from a multi‐center database. Cut‐off values of 5 and 190 were defined as elevated NLR and PLR, respectively, and long‐term outcome was assessed. Results Among 84 patients with ACC, 29 (34.%) had NLR > 5 while 32 (40.5%) had PLR > 190. NLR and PLR were associated with larger tumors (NLR > 5: ≤5 cm, 0% vs. >5 cm, 39.7%; PLR > 190: ≤ 5cm, 0% vs. >5 cm, 45.7%), as well as need to resect of other organs (NLR > 5: other organ resected 48.8% vs. not resected 20.9%; PLR > 190: other organ resected 25.0% vs. not resected 56.4%)(all P < 0.05). Five‐year RFS was associated with an elevated NLR (NLR ≤ 5, 14.2% vs. NLR> 5, 10.5%) and PLR (PLR ≤ 190: 19.4% vs. PLR > 190: 5.2%) (both P < 0.05). On multivariate survival analyses, PLR remained a predictor of RFS (HR 1.72), while NLR was associated with both DSS (HR 2.21) and RFS (HR 1.99) (both P < 0.05). Conclusions Immune markers such as NLR and PLR may be useful to stratify patients with regards to prognosis following surgery for ACC. J. Surg. Oncol. 2015 111:164–172 . © 2015 Wiley Periodicals, Inc.