title: Pretreatment neutrophil count as an independent prognostic factor in advanced non-small-cell lung cancer: an analysis of Japan Multinational Trial Organisation LC00-03.
abstract: We examined the impact of pretreatment neutrophil count on survival in patients with advanced non-small-cell lung cancer (NSCLC). A total of 388 chemo-naïve patients with stage IIIB or IV NSCLC from a randomised controlled trial were evaluated. The effects of pretreatment peripheral blood neutrophil, lymphocyte and monocyte counts and neutrophil-lymphocyte ratio on survival were examined using the proportional hazards regression model to estimate hazard ratios after adjustment for covariates. The optimal cut-off value was determined by proportional hazards regression analysis with the minimum P-value approach and shrinkage procedure. After adjustment for prognostic factors, the pretreatment elevated neutrophil count was statistically significantly associated with short overall (P=0.0008) and progression-free survival (P=0.024), whereas no association was found between prognosis and lymphocyte or monocyte count. The cut-off value selected for neutrophil count was 4500 mm(-3) (corrected hazard ratio, 1.67; 95% confidence interval (CI), 1.09-2.54). The median survival time was 19.3 months (95%CI, 16.5-21.4) for the low-neutrophil group (4500 mm(-3), n=204) and was 10.2 months (95%CI, 8.0-12.3) for the high-neutrophil group (4500 mm(-3), n=184). We confirmed that pretreatment elevated neutrophil count is an independent prognostic factor in patients with advanced NSCLC receiving modern chemotherapy. Neutrophil count is easily measured at low cost, and it may be a useful indicator of patient prognosis.
authors.affiliation: Department of Clinical Trial Design and Management, Translational Research Center, Kyoto University Hospital, Kyoto 606-8507, Japan. steramu@kuhp.kyoto-u.ac.jp
authors.forename: Satoshi
authors.initials: S
authors.lastname: Teramukai
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Kitano
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kishida
authors.forename: Masaaki
authors.initials: M
authors.lastname: Kawahara
authors.forename: Kaoru
authors.initials: K
authors.lastname: Kubota
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Komuta
authors.forename: Koichi
authors.initials: K
authors.lastname: Minato
authors.forename: Tadashi
authors.initials: T
authors.lastname: Mio
authors.forename: Yuka
authors.initials: Y
authors.lastname: Fujita
authors.forename: Toshiro
authors.initials: T
authors.lastname: Yonei
authors.forename: Kikuo
authors.initials: K
authors.lastname: Nakano
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tsuboi
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Shibata
authors.forename: Kiyoyuki
authors.initials: K
authors.lastname: Furuse
authors.forename: Masanori
authors.initials: M
authors.lastname: Fukushima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000276:immunology*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D007958:Leukocyte Count; D008175:Lung Neoplasms / Q000188:drug therapy / Q000276:immunology* / Q000401:mortality; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D009000:Monocytes; D015999:Multivariate Analysis; D009504:Neutrophils; D011379:Prognosis; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents