title: The derived neutrophil/lymphocyte ratio predicts poor clinical outcome in soft tissue sarcoma patients.
abstract: BACKGROUND
  Inflammation plays an important role in tumor proliferation and survival in cancer patients. The aim of this study was to investigate the prognostic impact of the pre-operative-derived neutrophil/lymphocyte ratio (dNLR) in a large cohort of soft tissue sarcoma (STS) patients after curative surgical resection.
  
  
  METHODS
  The impact of preoperative dNLR on disease-free survival (DFS) and overall survival (OS) in retrospectively evaluated 340 STS patients was assessed using Kaplan-Meier curves and Cox proportional models.
  
  
  RESULTS
  Applying receiver operating curve analysis, we determined a cut-off value of 2.39 for the dNLR to be optimal for discrimination of patients' survival in the whole cohort. Kaplan-Meier curves revealed a dNLR greater than or equal to 2.39 as a marker for decreased DFS (P = .031) and OS (P = .007, log-rank test) in STS patients. In multivariate analysis, increased dNLR was significantly associated with poor OS (hazard ratio 1.60, 95% confidence interval 1.07 to 2.40, P = .022).
  
  
  CONCLUSIONS
  This study demonstrates that preoperative dNLR might represent a well-correlated surrogate marker for the widely validated NLR. The dNLR is easily obtainable and can provide important information for individual risk assessment in clinical trials.
authors.affiliation: Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria; Research Unit Genetic Epidemiology and Pharmacogenetics, Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria. Electronic address: joanna.szkandera@medunigraz.at.
authors.forename: Joanna
authors.initials: J
authors.lastname: Szkandera
authors.affiliation: Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria; Research Unit Genetic Epidemiology and Pharmacogenetics, Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Armin
authors.initials: A
authors.lastname: Gerger
authors.affiliation: Institute of Pathology, Medical University of Graz, Graz, Austria.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Liegl-Atzwanger
authors.affiliation: Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria; Research Unit Genetic Epidemiology and Pharmacogenetics, Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Stotz
authors.affiliation: Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Hellmut
authors.initials: H
authors.lastname: Samonigg
authors.affiliation: Department of Orthopaedic Surgery, Medical University of Graz, Graz, Austria.
authors.forename: Joerg
authors.initials: J
authors.lastname: Friesenbichler
authors.affiliation: Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Stojakovic
authors.affiliation: Department of Orthopaedic Surgery, Medical University of Graz, Graz, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Leithner
authors.affiliation: Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Pichler
mesh_terms: D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012509:Sarcoma / Q000097:blood* / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000097:blood* / Q000601:surgery*; D016896:Treatment Outcome
keywords: Derived neutrophil/lymphocyte ratio; Inflammation; Prognostic marker; Soft tissue sarcoma