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Dynamic perioperative variation of neutrophil-to-lymphocyte ratio as an independent prognosis factor following lobectomy for NSCLC

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Abstract

Inflammation plays a key role in malignant tumor progression. The neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation and, as such, high isolated pretreatment NLR has been shown to be associated with worse long-term outcomes. The aim of the present study is to evaluate the prognostic value of pre- and post-operative NLR in relation to mortality and recurrence rates in patients undergoing lung lobectomy for NSCLC. A single-center retrospective analysis of 534 lobectomies was performed between 2009 and 2018. NLR was measured in two opportunities: 1 month prior to surgery and 1–4 months after. Primary outcomes were overall survival (OS) and recurrence-free survival (RFS). Secondary outcomes were variables associated with mortality and recurrence. The study sample included 264 lobectomies. Independent predictors of OS were ASA 3/4 (p = 0.041) and open surgical approach (p = 0.042). Adjuvant chemotherapy (p = 0.002) and pathological N 1/2-stage (p = 0.0015) were associated with RFS. Delta NLR correlated with OS (p = 0.042) and RFS (p < 0.001). Patients were divided into three delta NLR categories: delta NLR < 0, delta NLR 0–0.5 and delta NLR > 0.5. Increasing delta NLR was significantly associated with worse OS (p < 0.001) and RFS (p < 0.001). Dynamic behaviour of NLR assessed through delta NLR is a useful tool that potentially allows predicting mortality and recurrence outcomes in patients undergoing lung lobectomy for NSCLC and may be more informative than static baseline values.

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Abbreviations

NLR:

Neutrophil–lymphocyte ratio

OS:

Overall survival

RFS:

Recurrence-free survival

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of General Surgery, Hospital Italiano de Buenos Aires, Juan D. Perón 4190, C1199ABD, Buenos Aires, Argentina

    Raices Micaela, Caram Lucas & Corvatta Franco

  2. Department of Oncology, Hospital Italiano de Buenos Aires, Juan D. Perón 4190, C1199ABD, Buenos Aires, Argentina

    Cayol Federico

  3. Department of Thoracic Surgery and Pulmonary Transplantation, Hospital Italiano de Buenos Aires, Juan D. Perón 4190, C1199ABD, Buenos Aires, Argentina

    Dietrich Agustín & Smith David

Authors
  1. Raices Micaela
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  2. Caram Lucas
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  3. Corvatta Franco
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  4. Cayol Federico
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  5. Dietrich Agustín
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  6. Smith David
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Contributions

RM: conceptualization, formal analysis, writing-original draft, writing-review and editing, visualization. CL: formal analysis, writing-review and editing, visualization. CF: formal analysis, writing-review and editing, visualization. CF: resources. DA: conceptualization, methodology, supervision. SD: project administration, supervision.

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Correspondence to Corvatta Franco.

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Micaela, R., Lucas, C., Franco, C. et al. Dynamic perioperative variation of neutrophil-to-lymphocyte ratio as an independent prognosis factor following lobectomy for NSCLC. Updates Surg 73, 1567–1574 (2021). https://doi.org/10.1007/s13304-020-00936-x

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  • DOI: https://doi.org/10.1007/s13304-020-00936-x

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