Elevated pretreatment n eutrophil/ w hite b lood c ell r atio and m onocyte/ l ymphocyte r atio predict poor survival in patients with curatively resected non‐small cell lung cancer: R esults from a large cohort

Background The prognostic values of p reoperative n eutrophil/ l ymphocyte r atio ( NLR ), monocyte/lymphocyte ratio ( MLR ), and platelet/lymphocyte ratio ( PLR ) in non‐small cell lung cancer ( NSCLC ) have been previously described. This study assessed the prognostic values of other pretreatment complete blood cell parameters in C hinese patients with curatively resected NSCLC . Methods A total of 1466 consecutive NSCLC patients who received curative surgery from J anuary 1, 2005 to D ecember 31, 2009 with complete data from pretreatment blood tests were enrolled in this retrospective study. Correlations between each blood test parameter and overall survival were examined by K aplan– M eier method or C ox proportional hazards regression, followed by a stratification analysis of significant variables. Results Optimal cut‐off values of 0.55 for n eutrophil/ w hite b lood c ell r atio ( NWR ), 0.28 for l ymphocyte/ w hite b lood c ell r atio ( LWR ), 0.09 for m onocyte/ w hite b lood c ell r atio ( MWR ), 2.06 for NLR , 0.35 for MLR , 204.00 for PLR , and 38.25 for p latelet/ w hite b lood c ell r atio ( PWR ) were identified using X ‐tile software. Univariate analysis suggested that NWR  ≥ 0.55, LWR  < 0.28, MWR  ≥ 0.09, NLR  ≥ 2.06, MLR  ≥ 0.35, and PLR  ≥ 204.00 predicted a poor prognosis in NSCLC patients. However, only NWR and MLR were identified as independent significant prognostic factors in multivariable analysis, especially in tumor node metastasis stage I and I/II/III NSCLC s. Conclusion Pretreatment NWR , MWR , LWR , NLR , MLR , and PLR values are associated with poor overall survival for patients with curatively resected NSCLC . NWR and MLR are independent prognostic factors in curatively resected NSCLC .