title: Neutrophil-Lymphocyte Ratio Predicts Survival in Terminal Cancer Patients.
abstract: BACKGROUND
  Neutrophil-lymphocyte count ratio (NLR) is a prognostic factor in cancer, although its prognostic significance in terminally ill cancer patients is not clear.
  
  
  OBJECTIVE
  We investigated the association of NLR with survival in patients with terminal cancer.
  
  
  METHODS
  We retrospectively investigated 205 consecutive patients with terminal cancer admitted to a palliative care unit during 2014.
  
  
  RESULTS
  The median value of NLR was 9.7. In univariable analysis, NLR of 10 or more was significantly associated with shorter survival and NLR further discriminated survival of each palliative prognostic index (PPI) group. In multivariable analysis, increased NLR (≥10) was associated with shorter survival (hazards ratio [HR] 1.54, p<0.005), along with poor performance status (HR 1.55, p < 0.011), high PPI score (HR 1.59, p<0.003), and hyperbilirubinemia (HR 1.84, p < 0.001).
  
  
  CONCLUSIONS
  Our results suggest that elevated NLR was an independent prognostic factor for poor survival in patients with terminal cancer.
authors.affiliation: 1 Department of Internal Medicine, Gil Medical Center, Gachon University , Incheon, Republic of Korea.
authors.forename: Hee Kyung
authors.initials: HK
authors.lastname: Ahn
authors.affiliation: 2 Department of Family Medicine, Gil Medical Center, Gachon University , Incheon, Republic of Korea.
authors.forename: In Cheol
authors.initials: IC
authors.lastname: Hwang
authors.affiliation: 3 Department of Obstetrics and Gynecology, Gil Medical Center, Gachon University , Incheon, Republic of Korea.
authors.forename: Ji Sung
authors.initials: JS
authors.lastname: Lee
authors.affiliation: 1 Department of Internal Medicine, Gil Medical Center, Gachon University , Incheon, Republic of Korea.
authors.forename: Sun Jin
authors.initials: SJ
authors.lastname: Sym
authors.affiliation: 1 Department of Internal Medicine, Gil Medical Center, Gachon University , Incheon, Republic of Korea.
authors.forename: Eun Kyung
authors.initials: EK
authors.lastname: Cho
authors.affiliation: 1 Department of Internal Medicine, Gil Medical Center, Gachon University , Incheon, Republic of Korea.
authors.forename: Dong Bok
authors.initials: DB
authors.lastname: Shin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000401:mortality*; D009504:Neutrophils; D010166:Palliative Care; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis