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Background  The neutrophil to lymphocyte ratio ( NLR ) was recently shown to be a remarkable prognostic factor in tumors. Moreover, some studies have indicated that the combination of  NLR  and platelet to lymphocyte ratio ( PLR ) could be a better prognostic factor. As the combined prognostic value of  NLR  and  PLR  in non‐small cell lung cancer ( NSCLC ) is not clear, we conducted this study to explore this further.    Methods  A total of 366 primary  NSCLC  patients with stage  III  or  IV  were finally included. The neutrophil, platelet, and lymphocyte counts were recorded before treatment was initiated.  NLR  and  PLR  were calculated and  NLR  > 2.68 or  PLR  > 119.50 was defined as elevated. Univariate and multivariate survival analyses were conducted to test their prognostic value.    Results  The median of  NLR  and  PLR  were 3.14 and 152.63, respectively, in all patients. It was indicated that  PLR  is linearly associated with  NLR .  PLR  is associated with survival, but is not an independent prognostic factor. Removing  NLR ,  PLR  is an independent prognostic factor (overall survival [ OS] : hazard ratio [ HR]  = 1.918,  P  = 0.003; progression‐free survival [ PFS] :  HR  = 1.822,  P  = 0.007 in condition of  NLR  ≤ 2.68). It was also indicated that elevated  NLR  is an independent prognostic factor ( OS :  HR  = 1.778,  P  = 0.009;  PFS :  HR  = 1.535,  P  = 0.022) in all patients.    Conclusions   PLR  is a useful complement of  NLR,  thus, advanced  NSCLC  patients could be divided into three prognostic groups prior to treatment: poor:  NLR  > 2.68; moderate:  NLR  ≤ 2.68 and  PLR  > 119.50; and good:  NLR  ≤ 2.68 and  PLR  ≤ 119.50.

thoracic cancer

Combination of platelet to lymphocyte ratio and neutrophil to lymphocyte ratio is a useful prognostic factor in advanced non‐small cell lung cancer patients