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Influence of neutrophil–lymphocyte ratio in prognosis of glioblastoma multiforme

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Abstract

Neutrophil–lymphocyte ratio (NLR) is a hematological marker of systemic inflammation and several studies demonstrate an association between a higher NLR and a worse prognosis in many malignancies. However, literature analyzing its prognostic value in glioblastoma multiforme (GBM) is still scarce. We intended to analyze the correlation of NLR with overall survival and progression-free survival in patients with GBM performing a retrospective review of the patients with diagnosis of GBM submitted to a resection surgery in the department of neurosurgery of a tertiary care hospital, between January/2005 and January/2013. 140 patients were included. Mean age at surgery was 62.9 ± 10.0 years and mean age at death was 64.4 ± 9.8 years. Mean overall survival was 19.4 ± 14.3 months and mean progression-free survival was 9.4 ± 8.7 months. There was no correlation of NLR, platelets-lymphocyte ratio (PLR) or absolute counts of neutrophils, lymphocytes and platelets with overall survival in multivariate analysis. However, a preoperative NLR ≤ 5 correlated with a shorter progression-free survival [HR 1.56 (SD 95% 1.04–2.34); p = 0.032]. We performed a subgroup analysis of patients who completed Stupp protocol. In this subgroup of 117 patients, a preoperative NLR > 7 correlated with a shorter overall survival [HR 1.65 (SD 95% 1.07–2.53); p = 0.023]. The results from our total cohort didn’t confirm the correlation between a higher NRL and worse survival in GBM. However, in the subgroup analysis of patients who completed Stupp protocol, a higher NLR was an independent prognostic factor to a shorter overall survival, similar to existent literature data about GBM.

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Authors and Affiliations

  1. Department of Neurology, Hospital São Sebastião, Entre Douro e Vouga Hospital Centre, Rua Dr. Cândido de Pinho, 4520-211, Santa Maria da Feira, Portugal

    Marta Lopes

  2. Department of Neurosurgery, Hospital São João, São João Hospital Centre, Oporto, Portugal

    Bruno Carvalho, Rui Vaz & Paulo Linhares

  3. Faculty of Medicine, Oporto University, Oporto, Portugal

    Bruno Carvalho, Rui Vaz & Paulo Linhares

  4. Neurosciences Center, Hospital CUF Porto, Oporto, Portugal

    Rui Vaz & Paulo Linhares

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  1. Marta Lopes
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  2. Bruno Carvalho
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  3. Rui Vaz
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  4. Paulo Linhares
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Correspondence to Marta Lopes.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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Lopes, M., Carvalho, B., Vaz, R. et al. Influence of neutrophil–lymphocyte ratio in prognosis of glioblastoma multiforme. J Neurooncol 136, 173–180 (2018). https://doi.org/10.1007/s11060-017-2641-3

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  • DOI: https://doi.org/10.1007/s11060-017-2641-3

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