Elevated neutrophil to lymphocyte ratio predicts poor prognosis in nasopharyngeal carcinoma.
Elevated neutrophil to lymphocyte ratio (NLR) has been reported to be associated with worse survival in many malignancies, whereas its role in nasopharyngeal carcinoma (NPC) remains unclear. We retrospectively reviewed 363 consecutively, newly diagnosed, non-disseminated, and biopsy-proven NPC patients. Disease-specific survival (DSS), distant metastasis-free survival (DMFS), and locoregional recurrence-free survival (LRFS) rates were compared according to NLR level. Multivariate analysis was performed to assess the prognostic value of NLR. The 5-year DSS, DMFS, and LRFS rates for patients with elevated or non-elevated NLR (> or ≤3.73) were 59.6% vs. 76.6% (p = 0.03), 69.7% vs. 86.6% (p = 0.002), and 78.5% vs. 87.3% (p = 0.105), respectively. For patients with locoregionally advanced disease, NLR was not only an independent prognostic factor, but also a predictor of response to chemoradiotherapy. The 5-year DSS, DMFS, and LRFS rates for patients with elevated or non-elevated NLR were 47.2% vs. 73.7% (p < 0.001), 59.2% vs. 85.1% (p < 0.001), and 72.3% vs. 84.6% (p = 0.041), respectively. Compared with radiation alone, chemoradiotherapy significantly improved DSS and LRFS for patients with non-elevated NLR, but not for those with elevated NLR. Pre-treatment NLR is a strong prognostic factor for NPC patients. For patients with locoregionally advanced disease, NLR might also be a useful indicator for selection of treatment strategies.
State Key Laboratory of Oncology in South China, 651 Dongfeng East Road, Guangzhou, Guangdong 510060, People's Republic of China.
Xin
X
An
Pei-Rong
PR
Ding
Feng-Hua
FH
Wang
Wen-Qi
WQ
Jiang
Yu-Hong
YH
Li
D000293:Adolescent; D000328:Adult; D000368:Aged; D002452:Cell Count; D002648:Child; D003131:Combined Modality Therapy; D004358:Drug Therapy; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis* / Q000473:pathology* / Q000628:therapy; D009504:Neutrophils / Q000473:pathology*; D011379:Prognosis; D011878:Radiotherapy; D012189:Retrospective Studies; D055502:Secondary Prevention; D016019:Survival Analysis; D055815:Young Adult