Neutrophil-lymphocyte and platelet-lymphocyte ratio as predictors of disease specific survival after resection of adrenocortical carcinoma

Fabio Bagante; Thuy B. Tran; Lauren M. Postlewait; Shishir K. Maithel; Tracy S. Wang; Douglas B. Evans; Ioannis Hatzaras; Rivfka Shenoy; John E. Phay; Kara Keplinger; Ryan C. Fields; Linda X. Jin; Sharon M. Weber; Ahmed Salem; Jason K. Sicklick; Shady Gad; Adam C. Yopp; John C. Mansour; Quan Yang Duh; Natalie Seiser; Carmen C. Solorzano; Colleen M. Kiernan; Konstantinos I. Votanopoulos; Edward A. Levine; George A. Poultsides; Timothy M. Pawlik

doi:10.1002/jso.23982

Neutrophil-lymphocyte and platelet-lymphocyte ratio as predictors of disease specific survival after resection of adrenocortical carcinoma

Fabio Bagante, Thuy B. Tran, Lauren M. Postlewait, Shishir K. Maithel, Tracy S. Wang, Douglas B. Evans, Ioannis Hatzaras, Rivfka Shenoy, John E. Phay, Kara Keplinger, Ryan C. Fields, Linda X. Jin, Sharon M. Weber, Ahmed Salem, Jason K. Sicklick, Shady Gad, Adam C. Yopp, John C. Mansour, Quan Yang Duh, Natalie SeiserCarmen C. Solorzano, Colleen M. Kiernan, Konstantinos I. Votanopoulos, Edward A. Levine, George A. Poultsides, Timothy M. Pawlik

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Abstract

Background The systemic inflammatory response may be associated with tumor progression. We sought to analyze the impact of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) on recurrence-free survival (RFS) and disease-specific survival (DSS) among patients who underwent surgery for adrenocortical carcinoma (ACC). Methods Patients undergoing surgery for ACC were identified from a multi-center database. Cut-off values of 5 and 190 were defined as elevated NLR and PLR, respectively, and long-term outcome was assessed. Results Among 84 patients with ACC, 29 (34.%) had NLR>5 while 32 (40.5%) had PLR>190. NLR and PLR were associated with larger tumors (NLR>5: ≤5cm, 0% vs. >5cm, 39.7%; PLR>190: ≤5cm, 0% vs. >5cm, 45.7%), as well as need to resect of other organs (NLR>5: other organ resected 48.8% vs. not resected 20.9%; PLR>190: other organ resected 25.0% vs. not resected 56.4%)(all P<0.05). Five-year RFS was associated with an elevated NLR (NLR≤5, 14.2% vs. NLR>5, 10.5%) and PLR (PLR≤190: 19.4% vs. PLR>190: 5.2%) (both P<0.05). On multivariate survival analyses, PLR remained a predictor of RFS (HR 1.72), while NLR was associated with both DSS (HR 2.21) and RFS (HR 1.99) (both P<0.05). Conclusions Immune markers such as NLR and PLR may be useful to stratify patients with regards to prognosis following surgery for ACC. J. Surg. Oncol. 2015 111:164-172.

Original language	English (US)
Pages (from-to)	164-172
Number of pages	9
Journal	Journal of Surgical Oncology
Volume	112
Issue number	2
DOIs	https://doi.org/10.1002/jso.23982
State	Published - Aug 1 2015

Keywords

adrenocortical carcinoma
neutrophil-lymphocyte ratio
platelet-lymphocyte ratio
prognosis

ASJC Scopus subject areas

Surgery
Oncology

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10.1002/jso.23982

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Bagante, F., Tran, T. B., Postlewait, L. M., Maithel, S. K., Wang, T. S., Evans, D. B., Hatzaras, I., Shenoy, R., Phay, J. E., Keplinger, K., Fields, R. C., Jin, L. X., Weber, S. M., Salem, A., Sicklick, J. K., Gad, S., Yopp, A. C., Mansour, J. C., Duh, Q. Y., ... Pawlik, T. M. (2015). Neutrophil-lymphocyte and platelet-lymphocyte ratio as predictors of disease specific survival after resection of adrenocortical carcinoma. Journal of Surgical Oncology, 112(2), 164-172. https://doi.org/10.1002/jso.23982

Bagante, F, Tran, TB, Postlewait, LM, Maithel, SK, Wang, TS, Evans, DB, Hatzaras, I, Shenoy, R, Phay, JE, Keplinger, K, Fields, RC, Jin, LX, Weber, SM, Salem, A, Sicklick, JK, Gad, S, Yopp, AC , Mansour, JC, Duh, QY, Seiser, N, Solorzano, CC, Kiernan, CM, Votanopoulos, KI, Levine, EA, Poultsides, GA & Pawlik, TM 2015, 'Neutrophil-lymphocyte and platelet-lymphocyte ratio as predictors of disease specific survival after resection of adrenocortical carcinoma', Journal of Surgical Oncology, vol. 112, no. 2, pp. 164-172. https://doi.org/10.1002/jso.23982

@article{05a107c7564b483f8a88c32c783c5ffe,

title = "Neutrophil-lymphocyte and platelet-lymphocyte ratio as predictors of disease specific survival after resection of adrenocortical carcinoma",

abstract = "Background The systemic inflammatory response may be associated with tumor progression. We sought to analyze the impact of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) on recurrence-free survival (RFS) and disease-specific survival (DSS) among patients who underwent surgery for adrenocortical carcinoma (ACC). Methods Patients undergoing surgery for ACC were identified from a multi-center database. Cut-off values of 5 and 190 were defined as elevated NLR and PLR, respectively, and long-term outcome was assessed. Results Among 84 patients with ACC, 29 (34.%) had NLR>5 while 32 (40.5%) had PLR>190. NLR and PLR were associated with larger tumors (NLR>5: ≤5cm, 0% vs. >5cm, 39.7%; PLR>190: ≤5cm, 0% vs. >5cm, 45.7%), as well as need to resect of other organs (NLR>5: other organ resected 48.8% vs. not resected 20.9%; PLR>190: other organ resected 25.0% vs. not resected 56.4%)(all P<0.05). Five-year RFS was associated with an elevated NLR (NLR≤5, 14.2% vs. NLR>5, 10.5%) and PLR (PLR≤190: 19.4% vs. PLR>190: 5.2%) (both P<0.05). On multivariate survival analyses, PLR remained a predictor of RFS (HR 1.72), while NLR was associated with both DSS (HR 2.21) and RFS (HR 1.99) (both P<0.05). Conclusions Immune markers such as NLR and PLR may be useful to stratify patients with regards to prognosis following surgery for ACC. J. Surg. Oncol. 2015 111:164-172.",

keywords = "adrenocortical carcinoma, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, prognosis",

author = "Fabio Bagante and Tran, {Thuy B.} and Postlewait, {Lauren M.} and Maithel, {Shishir K.} and Wang, {Tracy S.} and Evans, {Douglas B.} and Ioannis Hatzaras and Rivfka Shenoy and Phay, {John E.} and Kara Keplinger and Fields, {Ryan C.} and Jin, {Linda X.} and Weber, {Sharon M.} and Ahmed Salem and Sicklick, {Jason K.} and Shady Gad and Yopp, {Adam C.} and Mansour, {John C.} and Duh, {Quan Yang} and Natalie Seiser and Solorzano, {Carmen C.} and Kiernan, {Colleen M.} and Votanopoulos, {Konstantinos I.} and Levine, {Edward A.} and Poultsides, {George A.} and Pawlik, {Timothy M.}",

note = "Publisher Copyright: {\textcopyright} 2015 Wiley Periodicals, Inc. {\textcopyright} 2015 Wiley Periodicals, Inc.",

year = "2015",

month = aug,

day = "1",

doi = "10.1002/jso.23982",

language = "English (US)",

volume = "112",

pages = "164--172",

journal = "Journal of Surgical Oncology",

issn = "0022-4790",

publisher = "Wiley-Liss Inc.",

number = "2",

}

TY - JOUR

T1 - Neutrophil-lymphocyte and platelet-lymphocyte ratio as predictors of disease specific survival after resection of adrenocortical carcinoma

AU - Bagante, Fabio

AU - Tran, Thuy B.

AU - Postlewait, Lauren M.

AU - Maithel, Shishir K.

AU - Wang, Tracy S.

AU - Evans, Douglas B.

AU - Hatzaras, Ioannis

AU - Shenoy, Rivfka

AU - Phay, John E.

AU - Keplinger, Kara

AU - Fields, Ryan C.

AU - Jin, Linda X.

AU - Weber, Sharon M.

AU - Salem, Ahmed

AU - Sicklick, Jason K.

AU - Gad, Shady

AU - Yopp, Adam C.

AU - Mansour, John C.

AU - Duh, Quan Yang

AU - Seiser, Natalie

AU - Solorzano, Carmen C.

AU - Kiernan, Colleen M.

AU - Votanopoulos, Konstantinos I.

AU - Levine, Edward A.

AU - Poultsides, George A.

AU - Pawlik, Timothy M.

PY - 2015/8/1

Y1 - 2015/8/1

N2 - Background The systemic inflammatory response may be associated with tumor progression. We sought to analyze the impact of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) on recurrence-free survival (RFS) and disease-specific survival (DSS) among patients who underwent surgery for adrenocortical carcinoma (ACC). Methods Patients undergoing surgery for ACC were identified from a multi-center database. Cut-off values of 5 and 190 were defined as elevated NLR and PLR, respectively, and long-term outcome was assessed. Results Among 84 patients with ACC, 29 (34.%) had NLR>5 while 32 (40.5%) had PLR>190. NLR and PLR were associated with larger tumors (NLR>5: ≤5cm, 0% vs. >5cm, 39.7%; PLR>190: ≤5cm, 0% vs. >5cm, 45.7%), as well as need to resect of other organs (NLR>5: other organ resected 48.8% vs. not resected 20.9%; PLR>190: other organ resected 25.0% vs. not resected 56.4%)(all P<0.05). Five-year RFS was associated with an elevated NLR (NLR≤5, 14.2% vs. NLR>5, 10.5%) and PLR (PLR≤190: 19.4% vs. PLR>190: 5.2%) (both P<0.05). On multivariate survival analyses, PLR remained a predictor of RFS (HR 1.72), while NLR was associated with both DSS (HR 2.21) and RFS (HR 1.99) (both P<0.05). Conclusions Immune markers such as NLR and PLR may be useful to stratify patients with regards to prognosis following surgery for ACC. J. Surg. Oncol. 2015 111:164-172.

AB - Background The systemic inflammatory response may be associated with tumor progression. We sought to analyze the impact of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) on recurrence-free survival (RFS) and disease-specific survival (DSS) among patients who underwent surgery for adrenocortical carcinoma (ACC). Methods Patients undergoing surgery for ACC were identified from a multi-center database. Cut-off values of 5 and 190 were defined as elevated NLR and PLR, respectively, and long-term outcome was assessed. Results Among 84 patients with ACC, 29 (34.%) had NLR>5 while 32 (40.5%) had PLR>190. NLR and PLR were associated with larger tumors (NLR>5: ≤5cm, 0% vs. >5cm, 39.7%; PLR>190: ≤5cm, 0% vs. >5cm, 45.7%), as well as need to resect of other organs (NLR>5: other organ resected 48.8% vs. not resected 20.9%; PLR>190: other organ resected 25.0% vs. not resected 56.4%)(all P<0.05). Five-year RFS was associated with an elevated NLR (NLR≤5, 14.2% vs. NLR>5, 10.5%) and PLR (PLR≤190: 19.4% vs. PLR>190: 5.2%) (both P<0.05). On multivariate survival analyses, PLR remained a predictor of RFS (HR 1.72), while NLR was associated with both DSS (HR 2.21) and RFS (HR 1.99) (both P<0.05). Conclusions Immune markers such as NLR and PLR may be useful to stratify patients with regards to prognosis following surgery for ACC. J. Surg. Oncol. 2015 111:164-172.

KW - adrenocortical carcinoma

KW - neutrophil-lymphocyte ratio

KW - platelet-lymphocyte ratio

KW - prognosis

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Neutrophil-lymphocyte and platelet-lymphocyte ratio as predictors of disease specific survival after resection of adrenocortical carcinoma

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