Neutrophil-lymphcyte ratio predicts survival in patients with terminally Ill cancer
演題番号 : P52-3
1:Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center、2:Department of Family Medicine, Gachon University Gil Medical Center
Neutrophil-lyphocyte count ratio (NLR) is a prognostic factor in various cancer, however its prognostic significance in terminally ill cancer patients is not clear. We investigated the association of NLR with survival in patients with terminal cancer.
We retrospectively investigated 205 consecutive patients with terminal cancer admitted to a palliative care unit during 2014. NLR was calculated using the laboratory result performed on the first admitted day. Survival time, defined as the period from the day of first admission to the day of death, was calculated by the Kaplan-Meier method and compared with the log-rank test. Cox proportional hazard model was used for assessing hazard ratio (HR) of prognostic factors for survival.
The median value of NLR was 9.7, far higher than previously reported in patients with advanced cancer. In univariable analysis, increased NLR of >= 10 was significantly associated with shorter survival. Other significant factors for worse prognosis were followings: male gender, poor performance (ECOG PS 3,4), higher palliative prognostic index (PPI) score (>=6), presence of infection, thrombocytopenia, azotemia, hypoalbuminemia, hyperbilirubinemia, increased level of C-reactive protein. In multivariable analysis, increased NLR (>= 10) was an independent significant predictors for shorter survival (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).
Our results suggest that elevated NLR was an independent prognostic factor for poor survival in patients with terminally ill cancer.