High neutrophil-lymphocyte ratio is not independently associated with worse survival or recurrence in patients with extremity soft tissue sarcoma.


Journal

Surgery
ISSN: 1532-7361
Titre abrégé: Surgery
Pays: United States
ID NLM: 0417347

Informations de publication

Date de publication:
10 2020
Historique:
received: 02 02 2020
revised: 21 05 2020
accepted: 10 06 2020
pubmed: 2 8 2020
medline: 12 11 2020
entrez: 2 8 2020
Statut: ppublish

Résumé

Soft tissue sarcomas are a heterogenous group of neoplasms without well-validated biomarkers. Cancer-related inflammation is a known driver of tumor growth and progression. Recent studies have implicated a high circulating neutrophil-lymphocyte ratio as a surrogate marker for the inflammatory tumor microenvironment and a poor prognosticator in multiple solid tumors, including colorectal and pancreatic cancers. The impact of circulating neutrophil-lymphocyte ratio in soft tissue sarcomas has yet to be elucidated. We performed a retrospective analysis of patients undergoing curative resection for primary or recurrent extremity soft tissue sarcomas at academic centers within the US Sarcoma Collaborative. Neutrophil-lymphocyte ratio was calculated retrospectively in treatment-naïve patients using blood counts at or near diagnosis. A high neutrophil-lymphocyte ratio (≥4.5) was associated with worse survival on univariable analysis in patients with extremity soft tissue sarcomas (hazard ratio 2.07; 95% confidence interval, 1.54-2.8; P < .001). On multivariable analysis, increasing age (hazard ratio 1.03; 95% confidence interval, 1.02-1.04; P < .001), American Joint Committee on Cancer T3 (hazard ratio 1.89; 95% confidence interval, 1.16-3.09; P = .011), American Joint Committee on Cancer T4 (hazard ratio 2.36; 95% confidence interval, 1.42-3.92; P = .001), high tumor grade (hazard ratio 4.56; 95% confidence interval, 2.2-9.45; P < .001), and radiotherapy (hazard ratio 0.58; 95% confidence interval, 0.41-0.82; P = .002) were independently predictive of overall survival, but a high neutrophil-lymphocyte ratio was not predictive of survival (hazard ratio 1.26; 95% confidence interval, 0.87-1.82; P = .22). Tumor inflammation as measured by high pretreatment neutrophil-lymphocyte ratio was not independently associated with overall survival in patients undergoing resection for extremity soft tissue sarcomas.

Sections du résumé

BACKGROUND
Soft tissue sarcomas are a heterogenous group of neoplasms without well-validated biomarkers. Cancer-related inflammation is a known driver of tumor growth and progression. Recent studies have implicated a high circulating neutrophil-lymphocyte ratio as a surrogate marker for the inflammatory tumor microenvironment and a poor prognosticator in multiple solid tumors, including colorectal and pancreatic cancers. The impact of circulating neutrophil-lymphocyte ratio in soft tissue sarcomas has yet to be elucidated.
METHODS
We performed a retrospective analysis of patients undergoing curative resection for primary or recurrent extremity soft tissue sarcomas at academic centers within the US Sarcoma Collaborative. Neutrophil-lymphocyte ratio was calculated retrospectively in treatment-naïve patients using blood counts at or near diagnosis.
RESULTS
A high neutrophil-lymphocyte ratio (≥4.5) was associated with worse survival on univariable analysis in patients with extremity soft tissue sarcomas (hazard ratio 2.07; 95% confidence interval, 1.54-2.8; P < .001). On multivariable analysis, increasing age (hazard ratio 1.03; 95% confidence interval, 1.02-1.04; P < .001), American Joint Committee on Cancer T3 (hazard ratio 1.89; 95% confidence interval, 1.16-3.09; P = .011), American Joint Committee on Cancer T4 (hazard ratio 2.36; 95% confidence interval, 1.42-3.92; P = .001), high tumor grade (hazard ratio 4.56; 95% confidence interval, 2.2-9.45; P < .001), and radiotherapy (hazard ratio 0.58; 95% confidence interval, 0.41-0.82; P = .002) were independently predictive of overall survival, but a high neutrophil-lymphocyte ratio was not predictive of survival (hazard ratio 1.26; 95% confidence interval, 0.87-1.82; P = .22).
CONCLUSION
Tumor inflammation as measured by high pretreatment neutrophil-lymphocyte ratio was not independently associated with overall survival in patients undergoing resection for extremity soft tissue sarcomas.

Identifiants

pubmed: 32736869
pii: S0039-6060(20)30380-9
doi: 10.1016/j.surg.2020.06.017
pii:
doi:

Substances chimiques

Biomarkers, Tumor 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

760-767

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Auteurs

Erin A Strong (EA)

Department of Surgery, Medical College of Wisconsin, Milwaukee, WI.

Sandra H Park (SH)

Department of Surgery, Tufts University, Boston, MA.

Cecilia G Ethun (CG)

Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA.

Bonnie Chow (B)

Department of Surgery, Medical College of Wisconsin, Milwaukee, WI.

David King (D)

Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, WI.

Meena Bedi (M)

Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI.

John Charlson (J)

Department of Medicine, Medical College of Wisconsin, Milwaukee, WI.

Harveshp Mogal (H)

Department of Surgery, Medical College of Wisconsin, Milwaukee, WI.

Susan Tsai (S)

Department of Surgery, Medical College of Wisconsin, Milwaukee, WI.

Kathleen Christians (K)

Department of Surgery, Medical College of Wisconsin, Milwaukee, WI.

Thuy B Tran (TB)

Department of Surgery, Stanford University, Palo Alto, CA.

George Poultsides (G)

Department of Surgery, Stanford University, Palo Alto, CA.

Valerie Grignol (V)

Department of Surgery, The Ohio State University, Columbus, OH.

J Harrison Howard (JH)

Department of Surgery, The Ohio State University, Columbus, OH.

Jennifer Tseng (J)

Department of Surgery, University of Chicago Medicine, Chicago, IL.

Kevin K Roggin (KK)

Department of Surgery, University of Chicago Medicine, Chicago, IL.

Konstantinos Chouliaras (K)

Department of Surgery, Wake Forest University, Winston-Salem, NC.

Konstantinos Votanopoulos (K)

Department of Surgery, Wake Forest University, Winston-Salem, NC.

Darren Cullinan (D)

Department of Surgery, Washington University, St. Louis, MO.

Ryan C Fields (RC)

Department of Surgery, Washington University, St. Louis, MO.

T Clark Gamblin (TC)

Department of Surgery, Medical College of Wisconsin, Milwaukee, WI.

Kenneth Cardona (K)

Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA.

Callisia N Clarke (CN)

Department of Surgery, Medical College of Wisconsin, Milwaukee, WI. Electronic address: cnclarke@mcw.edu.

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