Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Nov 14:13:1235158.
doi: 10.3389/fonc.2023.1235158. eCollection 2023.

The combination of baseline neutrophil to lymphocyte ratio and dynamic changes during treatment can better predict the survival of osteosarcoma patients

Longqing Li #  1 , Ye Li #  1 , Minxun Lu  1 , Yitian Wang  1 , Zhuangzhuang Li  1 , Xin Hu  1 , Xuanhong He  1 , Taojun Gong  1 , Yi Luo  1 , Yong Zhou  1 , Li Min  1 , Chongqi Tu  1
Affiliations

The combination of baseline neutrophil to lymphocyte ratio and dynamic changes during treatment can better predict the survival of osteosarcoma patients

Longqing Li et al. Front Oncol. .

Abstract

Background: Osteosarcoma is a primary malignant bone tumor with a high metastatic potential that accounts for a significant proportion of all bone tumors. The prognosis for patients with metastatic or recurrence disease remains poor. The neutrophil-to-lymphocyte ratio (NLR) has become a potential prognostic biomarker for cancer. Recent evidence suggests that the dynamic changes in neutrophil-to-lymphocyte ratio (NLR) during treatment may be more informative in predicting patient prognosis, but the value of dynamic NLR in osteosarcoma has not yet been determined.

Methods: This retrospective study retrospectively analyzed the clinical information of 251 osteosarcoma patients diagnosed and treated in West China Hospital of Sichuan University, explored the impact of baseline NLR and changes in NLR during treatment on the prognosis of osteosarcoma patients, and further combined baseline NLR with Delta NLR to build an NLR staging system.

Results: The results showed that both baseline NLR and delta NLR had some predictive ability for the prognosis of osteosarcoma patients (P = 6.90e-4, P = 0.022). Patients with high baseline NLR were more likely to have a decrease in delta NLR (P = 1.24e-10). The NLR stage had a better predictive ability than baseline NLR and delta NLR, and was an independent prognostic factor for overall survival in osteosarcoma patients HR: 2.456 (1.625-3.710) (P = 1.97e-05).

Conclusion: NLR has value in continuous monitoring, and continuous monitoring of NLR can better predict the survival of osteosarcoma patients compared to baseline NLR.

Keywords: neutrophils-to-lymphocytes ratio; osteosarcoma; prognosis; risk model; survival.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Relationship between baseline NLR and Delta NLR and prognosis of patients with osteosarcoma. (A) ROC results showing the optimal cutoff value for baseline NLR; (B) Kaplan-Meier survival curve for overall survival in patients with osteosarcoma at different baselines NLR; (C) Kaplan-Meier survival curve for overall survival in patients with osteosarcoma at different delta NLR; (D) Box violin plot showing the difference of baseline NLR of patients in different Delta NLR groups.
Figure 2
Figure 2
The NLR stage combining the baseline NLR and Delta NLR can more accurately identify the prognosis of osteosarcoma patients. (A) Kaplan-Meier survival curves for the overall survival of osteosarcoma patients in different groups when the NLR stage is divided into four groups; (B) Kaplan Meier survival curves for the overall survival of osteosarcoma patients in the Light and Moderate groups when the NLR stage is divided into four groups; (C) Kaplan-Meier survival curves for the overall survival of osteosarcoma patients in different groups when the NLR stage is divided into three groups; (D) The time dependent ROC curve of AUC value change of baseline NLR, Delta NLR and NLR stage at different time points.
Figure 3
Figure 3
NLR stage is an independent prognostic factor for patients with osteosarcoma. (A) Forest plot showing the results of univariate cox regression analysis for patients with osteosarcoma; (B) Forest plot showing the results of multivariate cox regression analysis for patients with osteosarcoma.
Figure 4
Figure 4
Constructing a column chart that can predict overall survival of patients with osteosarcoma. (A) A nomogram for predicting overall survival of osteosarcoma patients by introducing NLR stage; (B) Calibration chart to verify the accuracy of the nomogram; (C) Net benefit curve of nomogram; (D) Net reduction curve of nomogram.
Figure 5
Figure 5
Brief process of hematological testing and calculation.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Mirabello L, Troisi RJ, Savage SA. International osteosarcoma incidence patterns in children and adolescents, middle ages and elderly persons. Int J Cancer (2009) 125:229–34. doi: 10.1002/ijc.24320 - DOI - PMC - PubMed
    1. Mirabello L, Troisi RJ, Savage SA. Osteosarcoma incidence and survival rates from 1973 to 2004: data from the Surveillance, Epidemiology, and End Results Program. Cancer (2009) 115:1531–43. doi: 10.1002/cncr.24121 - DOI - PMC - PubMed
    1. Whelan JS, Davis LE. Osteosarcoma, chondrosarcoma, and chordoma. J Clin Oncol (2018) 36:188–93. doi: 10.1200/JCO.2017.75.1743 - DOI - PubMed
    1. Aljubran AH, Griffin A, Pintilie M, Blackstein M. Osteosarcoma in adolescents and adults: survival analysis with and without lung metastases. Ann Oncol (2009) 20:1136–41. doi: 10.1093/annonc/mdn731 - DOI - PubMed
    1. Lavit E, Aldea M, Piperno-Neumann S, Firmin N, Italiano A, Isambert N, et al. Treatment of 120 adult osteosarcoma patients with metachronous and synchronous metastases: A retrospective series of the French Sarcoma Group. Int J Cancer (2022) 150:645–53. doi: 10.1002/ijc.33823 - DOI - PubMed

LinkOut - more resources