title: Elevated preoperative neutrophil/lymphocyte ratio is associated with poor prognosis in soft-tissue sarcoma patients.
abstract: BACKGROUND
  Recent data indicate that tumour microenvironment, which is influenced by inflammatory cells, has a crucial role in cancer progression and clinical outcome of patients. In the present study, we investigated the prognostic relevance of preoperative neutrophil/lymphocyte (N/L) ratio on time to tumour recurrence (TTR) and overall survival (OS) in soft-tissue sarcoma (STS) patients who underwent curative surgical resection.
  
  
  METHODS
  In all, 260 STS patients were included in this retrospective study. Kaplan-Meier curves and multivariate Cox proportional models were calculated for TTR and OS.
  
  
  RESULTS
  In univariate analysis, elevated N/L ratio was significantly associated with decreased TTR (hazard ratio (HR), 2.32; 95% confidence interval (CI), 1.30-4.14; P=0.005) and remained significant in the multivariate analysis (HR, 1.98; 95%CI, 1.05-3.71; P=0.035). Patients with elevated N/L ratio showed a median TTR of 77.9 months. In contrast, patients with low N/L ratio had a median TTR of 99.1 months. Regarding OS, elevated N/L ratio was also significantly associated with decreased survival in univariate analysis (HR, 2.90; 95%CI, 1.82-4.61; P=0.001) and remained significant in multivariate analysis (HR, 1.88; 95%CI, 1.14-3.12; P=0.014).
  
  
  CONCLUSIONS
  In conclusion, our findings suggest that an elevated preoperative N/L ratio predicts poor clinical outcome in STS patients and may serve as a cost-effective and broadly available independent prognostic biomarker.
authors.affiliation: Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria.
authors.forename: J
authors.initials: J
authors.lastname: Szkandera
authors.forename: G
authors.initials: G
authors.lastname: Absenger
authors.forename: B
authors.initials: B
authors.lastname: Liegl-Atzwanger
authors.forename: M
authors.initials: M
authors.lastname: Pichler
authors.forename: M
authors.initials: M
authors.lastname: Stotz
authors.forename: H
authors.initials: H
authors.lastname: Samonigg
authors.forename: M
authors.initials: M
authors.lastname: Glehr
authors.forename: M
authors.initials: M
authors.lastname: Zacherl
authors.forename: T
authors.initials: T
authors.lastname: Stojakovic
authors.forename: A
authors.initials: A
authors.lastname: Gerger
authors.forename: A
authors.initials: A
authors.lastname: Leithner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008214:Lymphocytes / Q000473:pathology*; D008875:Middle Aged; D009504:Neutrophils / Q000473:pathology*; D011300:Preoperative Care; D011379:Prognosis; D012509:Sarcoma / Q000097:blood* / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D059016:Tumor Microenvironment; D055815:Young Adult
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