title: Prognostic performance of pre-treatment NLR and PLR in patients suffering from osteosarcoma.
abstract: BACKGROUND
  Inflammatory response markers have been proposed to predict the clinical outcomes in various cancers. The aim of this study was to explore the influence of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) on the prognosis of osteosarcoma.
  
  
  METHODS
  Three hundred fifty-nine patients who underwent curative surgery for osteosarcoma were enrolled from 2005 to 2010. NLR and PLR were calculated from peripheral blood cell counts taken at pre-treatment. Optimal cutoff values of NLR and PLR were determined on the basis of receiver operating characteristic curve analysis. A predictive model was established to predict the clinical outcome for overall survival, and the predictive accuracy of this model was determined by concordance index (c-index).
  
  
  RESULTS
  Our results showed that advanced stage and metastasis at diagnosis were significantly associated with the high NLR and PLR groups. NLR was an independent prognostic indicator for overall survival (HR = 1.80, 95% CI = 1.35-2.41, P < 0.001) and progression-free survival (HR = 1.65, 95% CI = 1.26-2.15, P < 0.001), except for PLR. The nomogram could perform well in the prediction of overall survival in patients with osteosarcoma (c-index 0.829).
  
  
  CONCLUSIONS
  Our results suggest that both NLR and PLR can reflect clinical prognosis. NLR is more predictive of overall survival and progression-free survival than PLR.
authors.affiliation: Department of Nephrology, The Affiliated Jiangyin Hospital of Southeast University Medical College, Jiangyin, Jiangsu, 214400, China.
authors.forename: Wen-Kai
authors.initials: WK
authors.lastname: Xia
authors.affiliation: Department of Oncology, The Affiliated Jiangyin Hospital of Southeast University Medical College, 163 Shoushan Road, Jiangyin, Jiangsu, 214400, China.
authors.forename: Zhi-Li
authors.initials: ZL
authors.lastname: Liu
authors.affiliation: Department of Oncology, The Affiliated Jiangyin Hospital of Southeast University Medical College, 163 Shoushan Road, Jiangyin, Jiangsu, 214400, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Shen
authors.affiliation: Department of Oncology, The Affiliated Jiangyin Hospital of Southeast University Medical College, 163 Shoushan Road, Jiangyin, Jiangsu, 214400, China.
authors.forename: Qing-Feng
authors.initials: QF
authors.lastname: Lin
authors.affiliation: Department of Oncology, The Affiliated Jiangyin Hospital of Southeast University Medical College, 163 Shoushan Road, Jiangyin, Jiangsu, 214400, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Su
authors.affiliation: Department of Oncology, The Affiliated Jiangyin Hospital of Southeast University Medical College, 163 Shoushan Road, Jiangyin, Jiangsu, 214400, China. maowdjy@163.com.
authors.forename: Wei-Dong
authors.initials: WD
authors.lastname: Mao
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary* / Q000601:surgery; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D001792:Blood Platelets / Q000473:pathology*; D001859:Bone Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009504:Neutrophils / Q000473:pathology*; D012516:Osteosarcoma / Q000473:pathology* / Q000601:surgery; D011300:Preoperative Care; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor
keywords: NLR; Osteosarcoma; PLR; Prognosis