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Prognostic value of neutrophil-to-lymphocyte ratio and other inflammatory markers in patients with high-risk soft tissue sarcomas

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Abstract

Background

Soft tissue sarcomas (STS) have a high risk of relapse in spite of the use of (neo)adjuvant chemotherapy. In this context, looking for new prognostic biomarkers is an interesting field of research. Our aim is to analyze the prognostic impact of neutrophil-to-lymphocyte ratio (NLR) and other serum markers in patients with STS who received chemotherapy with curative intent.

Materials and methods

This is a retrospective observational study. We included all patients with STS (primary tumor, local recurrence or resected metastatic disease) treated with high-dose ifosfamide and epirubicin with curative intent from January 2007 to December 2018. The pretreatment NLR and other serum markers were calculated, selecting the median as the cut-off value for the survival and multivariate analysis.

Results

Seventy-nine patients were included. Median NLR, platelet-to-lymphocyte ratio (PLR) and lymphocyte-to-monocyte ratio (LMR) were 2.83, 174.05 and 3.25, respectively. Median progression-free survival (PFS) was significantly longer in patients with low NLR [not reached (NR) vs 21, 92 months, P < 0.01]. No significant differences were found for PFS regarding PLR or LMR. For overall survival (OS), a significant survival advantage was also found for patients with low NLR (NR vs 65.45 months, P = 0.01), without differences for PLR or LMR. In multivariate analysis, NLR remains an independent prognostic factor for PFS.

Conclusion

In our cohort, low NLR was significantly associated with a longer PFS and OS, and is consolidated as an independent prognostic factor.

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Funding

This work has not been supported by public grants or financial support. No sources of funding were used to assist in the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Medical Oncology, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain

    D. Viñal, D. Martinez, J. A. Garcia-Cuesta, L. Gutierrez-Sainz, S. Martinez-Recio, J. Villamayor, V. Martinez-Marin, A. Gallego, E. Espinosa, J. Feliu & A. Redondo

  2. Department of Orthopaedic Surgery, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046, Madrid, Spain

    E. Ortiz-Cruz

  3. Molecular Pathology and Therapeutic Targets Group, IdiPAZ, Madrid, Spain

    M. Mendiola & J. J. Pozo-Kreilinger

  4. Department of Pathology, Hospital Universitario La Paz, Madrid, Spain

    J. J. Pozo-Kreilinger & A. Berjon

  5. Department of Radiation Oncology, Hospital Universitario La Paz, Madrid, Spain

    B. Belinchon

  6. Department of Radiology, Hospital Universitario La Paz, Madrid, Spain

    D. Bernabeu

  7. Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain

    J. J. Pozo-Kreilinger, E. Espinosa, J. Feliu & A. Redondo

  8. Translational Oncology Group, IdiPAZ, Madrid, Spain

    V. Martinez-Marin, E. Espinosa, J. Feliu & A. Redondo

  9. CIBERONC, Madrid, Spain

    M. Mendiola, E. Espinosa & J. Feliu

  10. Cátedra UAM-AMGEN, Madrid, Spain

    E. Espinosa, J. Feliu & A. Redondo

Authors
  1. D. Viñal
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  2. D. Martinez
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  3. J. A. Garcia-Cuesta
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  17. A. Redondo
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Contributions

Conceptualization: Andres Redondo, David Viñal; data collection: David Viñal, Daniel Martinez, Jose Angel Garcia-Cuesta, Laura Gutierrez-Sainz, Sergio Martinez-Recio, Julia Villamayor; data analysis: David Viñal, Daniel Martinez, Laura Gutierrez, Sergio Martinez-Recio. writing—original draft preparation: David Viñal, Daniel Martinez, Andres Redondo; writing—review and editing: Virginia Martinez-Marin, Alejandro Gallego, Eduardo Ortiz-Cruz, Marta Mendiola, Jose Juan Pozo-Kreilinger, Alberto Berjon, Belen Belinchon, Daniel Bernabeu, Enrique Espinosa, Jaime Feliu, Andres Redondo; supervision: Andres Redondo, Jaime Feliu.

Corresponding author

Correspondence to A. Redondo.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Ethics Committee of the La Paz University Hospital. This article does not contain any studies with animals performed by any of the authors.

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Viñal, D., Martinez, D., Garcia-Cuesta, J.A. et al. Prognostic value of neutrophil-to-lymphocyte ratio and other inflammatory markers in patients with high-risk soft tissue sarcomas. Clin Transl Oncol 22, 1849–1856 (2020). https://doi.org/10.1007/s12094-020-02324-8

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