title: The combined use of the neutrophil-lymphocyte ratio and C-reactive protein level as prognostic predictors in adult patients with soft tissue sarcoma.
abstract: BACKGROUND
  The aim of this study was to determine whether the combined use of the C-reactive protein (CRP) level and neutrophil-lymphocyte ratio (NLR) before treatment predicts disease-specific survival in adult patients with soft tissue sarcoma (STS).
  
  
  METHODS
  We retrospectively reviewed 142 patients who presented with STS between 1995 and 2010.
  
  
  RESULTS
  The NLR varied from 0.54 to 7.59. An elevated CRP level was observed in 36 patients before treatment. The patients with both an elevated CRP level and high NLR had a poorer disease-specific survival (46% at 5 years) than the patients with both a normal CRP level and low NLR (87% at 5 years) (P = 0.0005). The patients with both an elevated CRP level and high NLR also had a poorer disease-specific survival than the patients with either an elevated CRP level or high NLR (75.6% at five years) (P = 0.03). There were no significantly prognostic differences between the patients with a normal CRP level and low NLR and those with either an elevated CRP level or high NLR (P = 0.18). A multivariate analysis also showed the preoperative NLR and CRP level to be independent predictors of survival.
  
  
  CONCLUSIONS
  We recommend the routine measurement of these markers to identify patients with a greater risk of death.
authors.affiliation: Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Nakamura
authors.forename: Akihiko
authors.initials: A
authors.lastname: Matsumine
authors.forename: Takao
authors.initials: T
authors.lastname: Matsubara
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Asanuma
authors.forename: Astumasa
authors.initials: A
authors.lastname: Uchida
authors.forename: Akihiro
authors.initials: A
authors.lastname: Sudo
mesh_terms: D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D006801:Humans; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012509:Sarcoma / Q000097:blood*; D015996:Survival Rate
chemical_list: D002097:C-Reactive Protein
keywords: C-reactive protein; Neutrophil-lymphocyte ratio; biomarker; soft tissue sarcoma; survival