title: Inverse Association between Platelet-Lymphocyte Ratio and Prognosis in Terminally Ill Cancer Patients: A Preliminary Study.
abstract: An elevated platelet-lymphocyte ratio (PLR) is an indicator for worse outcomes in cancer, but its significance at the end of life remains unclear.
  
  
  
  This study aimed to investigate the value of PLR as an independent prognostic factor in terminally ill cancer patients.
  
  
  
  This retrospective cohort study included 312 terminal cancer patients and was conducted in a palliative care unit of a tertiary cancer center. Patient demographic data, clinical information, and laboratory values, including complete blood cell count, were obtained. Survival was analyzed using the Kaplan-Meier method and log-rank test. The Cox proportional hazards model was used to identify independent prognostic factors for survival.
  
  
  
  Median survival was 16 days in patients with PLR ≥200 and 9 days in patients with PLR <200 (p = 0.008). Results of multivariate analysis showed that the following factors predicted worse survival: poor performance status (adjusted hazard ratio [aHR], 2.16; 95% confidence interval [CI], 1.50-3.09), azotemia (aHR, 1.43; 95% CI, 1.01-2.02), hypoalbuminemia (aHR, 1.55; 95% CI, 1.07-2.26), hyperbilirubinemia (aHR, 1.67; 95% CI, 1.23-2.29), elevated lactate dehydrogenase (aHR, 1.58; 95% CI, 1.11-2.26), high neutrophil-lymphocyte ratio (aHR, 1.49; 95% CI, 1.09-2.04), and low PLR (aHR, 1.46; 95% CI, 1.08-1.97).
  
  
  
  Although elevated PLR indicates worse outcomes in patients with solid tumors, decreased PLR was an independent prognostic factor for poor survival in cancer patients at the end of life.
authors.affiliation: 1 Department of Family Medicine, Gachon University Gil Medical Center , Incheon, Republic of Korea.
authors.forename: Yoonjoo
authors.initials: Y
authors.lastname: Lee
authors.affiliation: 1 Department of Family Medicine, Gachon University Gil Medical Center , Incheon, Republic of Korea.
authors.forename: Ye Won
authors.initials: YW
authors.lastname: Kim
authors.affiliation: 2 Department of Internal Medicine, Gachon University Gil Medical Center , Incheon, Republic of Korea.
authors.forename: Dong Kyun
authors.initials: DK
authors.lastname: Park
authors.affiliation: 1 Department of Family Medicine, Gachon University Gil Medical Center , Incheon, Republic of Korea.
authors.forename: In Cheol
authors.initials: IC
authors.lastname: Hwang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001792:Blood Platelets / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood* / Q000503:physiopathology*; D010976:Platelet Count; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D019452:Terminally Ill / Q000706:statistics & numerical data*
keywords: platelet–lymphocyte ratio; prognosis; terminal care