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. 2015 Aug;112(2):164-72.
doi: 10.1002/jso.23982. Epub 2015 Jul 31.

Neutrophil-lymphocyte and platelet-lymphocyte ratio as predictors of disease specific survival after resection of adrenocortical carcinoma

Fabio Bagante  1 , Thuy B Tran  2 , Lauren M Postlewait  3 , Shishir K Maithel  3 , Tracy S Wang  4 , Douglas B Evans  4 , Ioannis Hatzaras  5 , Rivfka Shenoy  5 , John E Phay  6 , Kara Keplinger  6 , Ryan C Fields  7 , Linda X Jin  7 , Sharon M Weber  8 , Ahmed Salem  8 , Jason K Sicklick  9 , Shady Gad  9 , Adam C Yopp  10 , John C Mansour  10 , Quan-Yang Duh  11 , Natalie Seiser  11 , Carmen C Solorzano  12 , Colleen M Kiernan  12 , Konstantinos I Votanopoulos  13 , Edward A Levine  13 , George A Poultsides  2 , Timothy M Pawlik  1
Affiliations

Neutrophil-lymphocyte and platelet-lymphocyte ratio as predictors of disease specific survival after resection of adrenocortical carcinoma

Fabio Bagante et al. J Surg Oncol. 2015 Aug.

Abstract

Background: The systemic inflammatory response may be associated with tumor progression. We sought to analyze the impact of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) on recurrence-free survival (RFS) and disease-specific survival (DSS) among patients who underwent surgery for adrenocortical carcinoma (ACC).

Methods: Patients undergoing surgery for ACC were identified from a multi-center database. Cut-off values of 5 and 190 were defined as elevated NLR and PLR, respectively, and long-term outcome was assessed.

Results: Among 84 patients with ACC, 29 (34.%) had NLR > 5 while 32 (40.5%) had PLR > 190. NLR and PLR were associated with larger tumors (NLR > 5: ≤ 5 cm, 0% vs. >5 cm, 39.7%; PLR > 190: ≤ 5cm, 0% vs. >5 cm, 45.7%), as well as need to resect of other organs (NLR > 5: other organ resected 48.8% vs. not resected 20.9%; PLR > 190: other organ resected 25.0% vs. not resected 56.4%)(all P < 0.05). Five-year RFS was associated with an elevated NLR (NLR ≤ 5, 14.2% vs. NLR> 5, 10.5%) and PLR (PLR ≤ 190: 19.4% vs. PLR > 190: 5.2%) (both P < 0.05). On multivariate survival analyses, PLR remained a predictor of RFS (HR 1.72), while NLR was associated with both DSS (HR 2.21) and RFS (HR 1.99) (both P < 0.05).

Conclusions: Immune markers such as NLR and PLR may be useful to stratify patients with regards to prognosis following surgery for ACC.

Keywords: adrenocortical carcinoma; neutrophil-lymphocyte ratio; platelet-lymphocyte ratio; prognosis.

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Conflict of interest statement

Conflict of interest: None.

Figures

Figure 1
Figure 1
Fig. 2
Fig. 2
Disease Specific Survival (DSS) Kaplan-Meier curves for patients who underwent surgery for adrenal cortical carcinoma stratified by (a) NLR and (b) PLR.
See this image and copyright information in PMC

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