Evaluation of Preoperative Hematologic Markers as Prognostic Factors and Establishment of Novel Risk Stratification in Resected pN0 Non-Small-Cell Lung Cancer

<div><p>Background</p><p>The aims of this study were to investigate whether the preoperative hematologic markers, the neutrophil-lymphocyte ratio (NLR) or the platelet-lymphocyte ratio (PLR) were prognostic indicators and to develop a novel risk stratification model in pN0 non-small-cell lung cancer (NSCLC).</p><p>Methods</p><p>We performed a retrospective analysis of 400 consecutive pN0 NSCLC patients. Prognostic values were evaluated by Cox proportional hazard model analyses and patients were stratified according to relative risks for patients’ survival.</p><p>Results</p><p>During the follow-up, 117 patients had cancer recurrence, and 86 patients died. In univariate analysis, age, gender, smoke status and tumor size as well as WBC, NEU, LYM, PLR and NLR were significantly associated with patients’ prognosis. In multivariate analysis, age, tumor size and NLR were independent predictors for patients’ overall survival (P = 0.024, 0.001, and 0.002 respectively). PLR didn’t associated with patients’ survival in multivariate analysis. Patients were stratified into 3 risk groups and the differences among the groups were significant according to disease free survival and overall survival (P = 0.000 and 0.000 respectively).</p><p>Conclusions</p><p>We confirmed that NLR other than PLR was an independent prognostic factor. Combination of NLR, age and tumor size could stratify pN0 NSCLC patients into 3 risk groups and enabled us to develop a novel risk stratification model.</p></div

Clinical characteristic of all 400 lung cancer patients.

<p>Clinical characteristic of all 400 lung cancer patients.</p

Distribution of clinical characteristics stratified by pretreatment NLR or PLR.

<p>Distribution of clinical characteristics stratified by pretreatment NLR or PLR.</p

Kaplan-Meier estimates according to low, intermediate and high risk groups on DFS (a) and OS (b).

<p>Kaplan-Meier estimates according to low, intermediate and high risk groups on DFS (a) and OS (b).</p

Kaplan-Meier estimates according to categorical age, tumor size, NLR and PLR on DFS (a, b, c, d) and OS (e, f, g, h).

<p>Kaplan-Meier estimates according to categorical age, tumor size, NLR and PLR on DFS (a, b, c, d) and OS (e, f, g, h).</p

Multivariate proportional hazards (Cox) regression analyses according to DFS and OS.

<p>Multivariate proportional hazards (Cox) regression analyses according to DFS and OS.</p