Pretreatment neutrophil count as an independent prognostic factor in advanced non-small-cell lung cancer: an analysis of Japan Multinational Trial Organisation LC00-03.
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.
Teramukai
Satoshi
S
Department of Clinical Trial Design and Management, Translational Research Center, Kyoto University Hospital, Kyoto 606-8507, Japan. steramu@kuhp.kyoto-u.ac.jp
Kitano
Toshiyuki
T
Kishida
Yusuke
Y
Kawahara
Masaaki
M
Kubota
Kaoru
K
Komuta
Kiyoshi
K
Minato
Koichi
K
Mio
Tadashi
T
Fujita
Yuka
Y
Yonei
Toshiro
T
Nakano
Kikuo
K
Tsuboi
Masahiro
M
Shibata
Kazuhiko
K
Furuse
Kiyoyuki
K
Fukushima
Masanori
M
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
D000970:Antineoplastic Agents