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The effect of platelet-to-lymphocyte ratıo (PLR) and glasgow prognostıc score (GPS) on recurrence, and survıval ın patıents undergoıng lobectomy for early-stage non-small cell lung cancer (NSCLC)

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Abstract

Tumor markers are indicators that can be used not only for cancer diagnosis but also for determining prognosis. Unfortunately, there is currently no tumor marker that reliably predicts the prognosis of lung cancer. In this study, we investigated the prognostic impact of the platelet-to-lymphocyte ratio (PLR) and Glasgow Prognostic Score (GPS), known as inflammation markers in peripheral blood, in patients who underwent resection for early-stage non-small cell lung cancer (NSCLC). We retrospectively analyzed the medical records of a total of 3300 patients who underwent surgery for NSCLC between 2010 and 2020. Among these patients, 250 met the inclusion criteria of lobectomy, pT1-T2N0 stage, and histology of adenocarcinoma or squamous cell carcinoma. Preoperative albumin, C-reactive protein (CRP), preoperative PLR, and postoperative 5th-day PLR values were determined from patient’s peripheral blood data. The impact of these values on postoperative recurrence and survival was investigated. GPS was calculated based on preoperative CRP and albumin values, and patients were divided into 3 groups: 0 (mild), 1 (moderate), and 2 (severe). The relationship between preoperative GPS and survival was analysed. Among the included patients, 155 (62%) had adenocarcinoma and 95 (38%) had squamous cell carcinoma. A total of 185 (74%) patients had pT1 tumors, while 65 (26%) had pT2 tumors. During the postoperative follow-up period, local recurrence was observed in 28 (11.2%) patients and distant metastasis in 51 (20.4%) patients. The overall mortality rate was 19.6%. The 5-year survival rates for pT1 and pT2 tumors were 80.4% and 72.5%, respectively. Significant associations were found between preoperative PLR, postoperative PLR, and recurrence (p = 0.005 and p = 0.011). The expected overall survival (OS) was 103.4 months in the mild GPS group, 91.8 months in the moderate GPS group, and 50 months in the severe GPS group. The relationship between GPS groups and OS was statistically significant (p = 0.005). Preoperative analysis of PLR and GPS may provide prognostic value in NSCLC patients who undergo surgical resection. Our study provides a rationale for further investigation of peripheral blood immune markers for prognostic purposes.

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All data generated or analysed during this study are included in this published article [and its supplementary information files].

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Authors and Affiliations

  1. Dr Suat Seren Chest Diseases and Chest Surgery Training and Research Hospital, University of Health Sciences Turkey, Izmir, Turkey

    Bahar Agaoglu Sanli, Serkan Yazgan & Ahmet Ucvet

  2. Van Training and Research Hospital, Thoracic Surgery Clinic, University of Health Sciences Turkey, Van, Turkey

    Barıs Gulmez

Authors
  1. Bahar Agaoglu Sanli
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  2. Barıs Gulmez
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  3. Serkan Yazgan
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  4. Ahmet Ucvet
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Correspondence to Bahar Agaoglu Sanli.

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Ethics committee of our hospital (2022/57-65) approved the protocol for the current study. All patients gave written informed consent for surgical treatment and were aware that all information could be used anonymously for scientific purposes only.

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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008. Informed consent was obtained from all participants.

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Agaoglu Sanli, B., Gulmez, B., Yazgan, S. et al. The effect of platelet-to-lymphocyte ratıo (PLR) and glasgow prognostıc score (GPS) on recurrence, and survıval ın patıents undergoıng lobectomy for early-stage non-small cell lung cancer (NSCLC). Updates Surg 76, 631–639 (2024). https://doi.org/10.1007/s13304-023-01669-3

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