title: Platelet-to-Lymphocyte Ratio and Use of NSAIDs During the Perioperative Period as Prognostic Indicators in Patients With NSCLC Undergoing Surgery.
abstract: BACKGROUND
  Hematological biomarkers of inflammation such as the neutrophil-to-lymphocytic rate have been reported as predictors of survival in a variety of cancers. The aim of the present study was to investigate the prognostic value of the perioperative platelet-to-lymphocyte ratio in patients with non-small-cell lung cancer (NSCLC) and to elucidate the effects of the perioperative use of nonsteroidal anti-inflammatory drugs (NSAIDs) on tumor recurrence and survival in patients undergoing surgical resection for NSCLC.
  
  
  METHODS
  This retrospective study included data from 1,637 patients who underwent surgical resection for stage I, II, or III NSCLC. Perioperative data and tumor-related variables were included. Univariate and multivariable Cox proportional hazard ratio (HR) models were used to evaluate the association between perioperative platelet-to-lymphocyte ratio and NSAID use on recurrence-free survival (RFS) and overall survival (OS).
  
  
  RESULTS
  Multivariate analysis showed that a preoperative platelet-to-lymphocyte ratio of at least 180 was associated with reduced rates of RFS (HR = 1.22; 95% confidence interval [CI], 1.03-1.45; P = .019) and OS (HR = 1.33; 95% CI, 1.10-1.62; P = .004). Perioperative use of NSAIDs showed no statistically significant changes in RFS and OS rates (P = .72 and P = .44, respectively).
  
  
  CONCLUSIONS
  A higher preoperative inflammatory status is associated with decreased rates of RFS and OS in patients with NSCLC undergoing curative surgery. Perioperative use of NSAIDs was not found to be an independent predictor of survival.
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, MD Anderson Cancer Center, Houston, TX 77030. jcata@mdanderson.org.
authors.forename: Brenda M
authors.initials: BM
authors.lastname: Lee
authors.forename: Andrea
authors.initials: A
authors.lastname: Rodriguez
authors.forename: Gabriel
authors.initials: G
authors.lastname: Mena
authors.forename: Vijaya
authors.initials: V
authors.lastname: Gottumukkala
authors.forename: Reza J
authors.initials: RJ
authors.lastname: Mehran
authors.forename: David C
authors.initials: DC
authors.lastname: Rice
authors.forename: Lei
authors.initials: L
authors.lastname: Feng
authors.forename: Jun
authors.initials: J
authors.lastname: Yu
authors.forename: Juan P
authors.initials: JP
authors.lastname: Cata
mesh_terms: D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D001792:Blood Platelets; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D059035:Perioperative Period; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal