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Prognostic significance of baseline neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) in patients (pts) with biliary tract cancer (BTC)
Tariq, N. U. A. Raja, H. Wang, Xin Mehta, S. Lamarca, Angela McNamara, Mairead G
Tariq, N. U. A.
Raja, H.
Wang, Xin
Mehta, S.
Lamarca, Angela
McNamara, Mairead G
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Abstract
Background: Biliary tract cancer is a poor prognosis disease. Due to the role of chronic
inflammation in the development of BTC, inflammatory markers such as NLR, PLR, and
SII might be useful as prognostic markers in this disease group.
Methods: Data from sequential pts with BTC referred to The Christie (Jan 2012 - Aug
2017) were reviewed retrospectively. Median (med) value was used to dichotomise
subgroups for baseline NLR, PLR and SII (Platelets x Neutrophils/Lymphocytes) for
balanced division of patients. The Kaplan-Meier survival method was used and association
of overall survival (OS) with different co-variables was analysed using Cox
proportional hazard regression.
Results: Data from 591 pts were included; median age was 69 years, 46% were males,
Eastern Co-operative Oncology Group performance status (ECOG PS) 1 was the commonest
PS (51.1%). Patients had extrahepatic cholangiocarcinoma (CCA): 32.3%,
intrahepatic CCA: 28.7%, gallbladder carcinoma: 20.6%, or ampulla of Vater carcinoma:
15.9%. Stage: 54.2% stage IV, 32.5% stage III, and 13.2% stage I/II; 89% of pts had died
at time of analysis. The cut-off for NLR was 3.64, PLR was 193.3 and SII was
1082.1. The median OS for the entire cohort was 13.4 months (mths) (95% Confidence
Interval [CI] 12-14.8); the 5-year survival rate was 5.1% (95%CI 3.3-7.9). The
multivariable analysis was adjusted for gender, age, stage, ECOG PS, treatment type,
and NLR, PLR and SII at baseline as these were significant at univariate analysis. On
multivariable analysis, NLR (HR 1.34, 95%CI 1.1-1.7, p¼0.01) and SII (HR 1.57, 95%CI
1.2-2.0, p<0.001) were both independent prognostic factors, with better OS in patients
with lower NLR (med OS 17.7 mths vs 9.2 mths, [95% CI 16.66-22.3], p<0.001) and
lower SII (med OS 17.9 mths vs 8.6 mths [95% CI 16.26-22.16], p<0.001).
Conclusions: Lower baseline NLR and SII were prognostic for better OS in pts with
BTC. Prospective studies are needed to explore the clinical prognostic relevance of
these markers.
Description
Date
2020
Publisher
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Keywords
Type
Meetings and Proceedings
Citation
Tariq NUA, Raja H, Wang X, Mehta S, Lamarca A, Hubner R, et al. 62P Prognostic significance of baseline neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) in patients (pts) with biliary tract cancer (BTC). Annals of Oncology. 2020;31:S265-S.