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Elevated Preoperative Neutrophil-Lymphocyte Ratio is Predictive of a Poorer Prognosis for Pediatric Patients with Solid Tumors.
Nayak, Agnish; McDowell, Dermot T; Kellie, Stewart J; Karpelowsky, Jonathan.
Afiliación
  • Nayak A; Faculty of Medicine, University of New South Wales, New South Wales, Australia.
  • McDowell DT; Division of Child and Adolescent Health, Sydney Medical School, The University of Sydney, New South Wales, Australia.
  • Kellie SJ; Department of Paediatric Surgery, The Children's Hospital at Westmead, Westmead, Australia.
  • Karpelowsky J; Division of Child and Adolescent Health, Sydney Medical School, The University of Sydney, New South Wales, Australia.
Ann Surg Oncol ; 24(11): 3456-3462, 2017 Oct.
Article en En | MEDLINE | ID: mdl-28718035
BACKGROUND: An elevated neutrophil-lymphocyte ratio (NLR) has been shown to indicate poorer prognosis for adults with solid tumors and potentially represents an independent, universal adjunct prognostic factor. The value of NLR in a pediatric setting has not been evaluated. This study sought to determine the prognostic value of NLR for pediatric patients with solid tumors. METHODS: Pediatric patients with solid tumors undergoing neoadjuvant chemotherapy followed by surgery with curative intent between 2000 and 2014 were eligible for this study. A preoperative peripheral blood count within 1 month of surgery taken after recovery from recent chemotherapy was analyzed in relation to overall survival (OS) and event-free survival (EFS). RESULTS: This retrospective study enrolled 293 patients. The median age at diagnosis was 46.5 months (range 0.1-206.1 months). Males accounted for 58% of the patients. The median OS was 49 months. An NLR cutoff of 2.5 was used in the analysis. In the univariate analysis, a high NLR was associated with low OS (p = 0.001) and low EFS (p = 0.020). Other factors identified in the univariate analysis that affected survival included metastatic disease at diagnosis (p < 0.001) and tumor type (p = 0.012). The multivariate analyses showed that a high NLR was associated with low OS (p = 0.014) but not with EFS (p = 0.270). The multivariate analysis of neuroblastoma patients found that a high NLR was associated with low OS (p = 0.013). CONCLUSIONS: An elevated NLR is prognostic of a poorer outcome for pediatric patients with solid tumors and potentially represents an independent, universal adjunct prognosticator in such cases.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cuidados Preoperatorios / Linfocitos / Recurrencia Local de Neoplasia / Neoplasias / Neutrófilos Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Newborn Idioma: En Revista: Ann Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2017 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cuidados Preoperatorios / Linfocitos / Recurrencia Local de Neoplasia / Neoplasias / Neutrófilos Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Newborn Idioma: En Revista: Ann Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2017 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Estados Unidos