Neutrophil-to-lymphocyte Ratio as a Predictor of Prognosis in Patients with Small Cell Lung Cancer: A Retrospective Study

Özet

Objective: Neutrophil-to-lymphocyte Ratio (NLR) is an easily measurable parameter with prognostic value for various types of cancer. The role of NLR in terms of prognosis in small cell lung cancer (SCLC) is controversial. The aim of this study was to investigate the relationship between NLR, platelet-to-lymphocyte ratio (PLR), other potential factors and prognosis in patients with SCLC. Methods: A retrospective cohort study enrolled 396 patients diagnosed with SCLC between January 1, 2008, and December 31, 2012 in the department of chest diseases of a tertiary hospital. Patients were grouped according to their NLR levels at the time of diagnosis; low-NLR (<4) (Group 1) and high-NLR (≥4) (Group 2). These groups were compared with the recorded data and predictors of mortality and the results were analyzed. Results: Patients with low-NLR (<4) (Group 1) had worse performance status, extensive stage, and lower response rate compared to patients with high-NLR (≥4) (Group 2). Median overall survival (OS) was worse in the high-NLR group than in the low-NLR group (Group 1). In contrast, elevated PLR was not associated with OS. Multivariate analysis showed that elevated NLR and lactate dehydrogenase, stage, smoking history, presence of malign pleural effusion were independent prognostic factors for OS. Conclusion: Elevated NLR is easily measurable can be used as a prognostic marker that reflects poor prognosis, while PLR is not associated with survival for patients with SCLC.