title: Neutrophil/lymphocyte ratio has a prognostic value for patients with terminal cancer.
abstract: BACKGROUND
  Determining prognosis in advanced cancer is of key importance. Various prognostic scores have been developed. However, they are often very complex. In this study, we evaluated the feasibility of neutrophil/lymphocyte ratio (NLR) as an index to estimate survival in terminal cancer patients.
  
  
  METHODS
  NLR was calculated retrospectively based on blood tests performed at 3 months, 2 months, 4 weeks, 3 weeks, 2 weeks, 1 week, and within 3 days before death in 160 cancer patients (82 men, 78 women; age range, 33-99 years; mean age, 69.8 years).
  
  
  RESULTS
  NLR increased significantly with time (P < 0.0001). Mean NLR was significantly higher in patients who died within 4 weeks (29.82) than in those who lived more than 4 weeks (6.15). The NLR cutoff point was set at 9.21 according to receiver operating characteristic curve analysis (area under the curve, 0.82; 95% confidence interval, 0.79-0.85). We inferred that life expectancy would be <4 weeks when NLR >9.21. The sensitivity, specificity, positive predictive value, and negative predictive value were 65.6, 84.1, 90.6, and 51.1%, respectively. The positive and negative likelihood ratios were 4.125 and 0.409, respectively.
  
  
  CONCLUSIONS
  NLR appears to be a useful and simple parameter to predict the clinical outcomes of patients with terminal cancer.
authors.affiliation: Palliative Care Team, Toho University Ohashi Medical Center, 2-17-6 Ohashi, Meguroku, Tokyo, 1538515, Japan. you1mac@mac.com.|Department of Surgery, Toho University Ohashi Medical Center, Meguroku, Tokyo, Japan. you1mac@mac.com.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Nakamura
authors.affiliation: Department of Surgery, Toho University Ohashi Medical Center, Meguroku, Tokyo, Japan.
authors.forename: Ryohei
authors.initials: R
authors.lastname: Watanabe
authors.affiliation: Department of Surgery, Toho University Ohashi Medical Center, Meguroku, Tokyo, Japan.
authors.forename: Miwa
authors.initials: M
authors.lastname: Katagiri
authors.affiliation: Department of Surgery, Toho University Ohashi Medical Center, Meguroku, Tokyo, Japan.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Saida
authors.affiliation: Department of Surgery, Toho University Ohashi Medical Center, Meguroku, Tokyo, Japan.
authors.forename: Natsuya
authors.initials: N
authors.lastname: Katada
authors.affiliation: Department of Surgery, Toho University Ohashi Medical Center, Meguroku, Tokyo, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Watanabe
authors.affiliation: Department of Surgery, Toho University Ohashi Medical Center, Meguroku, Tokyo, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Okamoto
authors.affiliation: Department of Surgery, Toho University Ohashi Medical Center, Meguroku, Tokyo, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Asai
authors.affiliation: Department of Surgery, Toho University Ohashi Medical Center, Meguroku, Tokyo, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Enomoto
authors.affiliation: Department of Surgery, Toho University Ohashi Medical Center, Meguroku, Tokyo, Japan.
authors.forename: Takaharu
authors.initials: T
authors.lastname: Kiribayashi
authors.affiliation: Department of Surgery, Toho University Ohashi Medical Center, Meguroku, Tokyo, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Kusachi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009369:Neoplasms / Q000473:pathology* / Q000628:therapy; D009504:Neutrophils / Q000473:pathology*; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D019452:Terminally Ill
chemical_list: D014408:Biomarkers, Tumor
keywords: Blood cells; Inflammation; Neoplasms; Palliative care; Prognosis