title: The prognostic impact of the neutrophil-to-lymphocyte ratio in patients with small-cell lung cancer.
abstract: BACKGROUND
  The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are prognostic factors for various types of cancer. In this study, we assessed the association of NLR and PLR with the prognosis of small-cell lung cancer (SCLC) in patients who received the standard treatment.
  
  
  METHODS
  We retrospectively reviewed patients who were diagnosed with SCLC and treated with platinum-based chemotherapy between July 2006 and October 2013 in Gyeongsang National University Hospital Regional Cancer Center and Changwon Samsung Hospital.
  
  
  RESULTS
  In total, 187 patients were evaluated. Compared with low NLR (<4), high NLR (⩾4) at diagnosis was associated with poor performance status, advanced stage, and lower response rate. Median overall survival (OS) and progression-free survival (PFS) were worse in the high-NLR group (high vs low, 11.17 vs 9.20 months, P=0.019 and 6.90 vs 5.49 months, P=0.005, respectively). In contrast, PLR at diagnosis was not associated with OS or PFS (P=0.467 and P=0.205, respectively). In multivariate analysis, stage, lactate dehydrogenase, and NLR at diagnosis were independent prognostic factors for OS and PFS.
  
  
  CONCLUSIONS
  NLR is easily measurable and reflects the SCLC prognosis. A future prospective study is warranted to confirm our results.
authors.affiliation: Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital Gyeongsang National University School of Medicine, Jinju, Republic of Korea.
authors.forename: M H
authors.initials: MH
authors.lastname: Kang
authors.affiliation: Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital Gyeongsang National University School of Medicine, Jinju, Republic of Korea.
authors.forename: S-I
authors.initials: SI
authors.lastname: Go
authors.affiliation: Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital Gyeongsang National University School of Medicine, Jinju, Republic of Korea.
authors.forename: H-N
authors.initials: HN
authors.lastname: Song
authors.affiliation: Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital Gyeongsang National University School of Medicine, Jinju, Republic of Korea.
authors.forename: A
authors.initials: A
authors.lastname: Lee
authors.affiliation: Division of Hematology and Medical Oncology, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea.
authors.forename: S-H
authors.initials: SH
authors.lastname: Kim
authors.affiliation: 1] Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital Gyeongsang National University School of Medicine, Jinju, Republic of Korea [2] Gyeongsang Institute of Health Sciences, Jinju, Republic of Korea.
authors.forename: J-H
authors.initials: JH
authors.lastname: Kang
authors.affiliation: Department of Radiation Oncology, Gyeongsang National University Hospital Gyeongsang National University School of Medicine, Jinju, Republic of Korea.
authors.forename: B-K
authors.initials: BK
authors.lastname: Jeong
authors.affiliation: Department of Radiation Oncology, Gyeongsang National University Hospital Gyeongsang National University School of Medicine, Jinju, Republic of Korea.
authors.forename: K M
authors.initials: KM
authors.lastname: Kang
authors.affiliation: Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: H
authors.initials: H
authors.lastname: Ling
authors.affiliation: 1] Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital Gyeongsang National University School of Medicine, Jinju, Republic of Korea [2] Gyeongsang Institute of Health Sciences, Jinju, Republic of Korea.
authors.forename: G-W
authors.initials: GW
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000188:drug therapy / Q000276:immunology* / Q000401:mortality; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009504:Neutrophils / Q000276:immunology*; D010976:Platelet Count; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D055752:Small Cell Lung Carcinoma / Q000188:drug therapy / Q000276:immunology* / Q000401:mortality; D016896:Treatment Outcome