Surgical Oncology Unit, Department of Surgery A, The Sackler Faculty of Medicine, Tel-Aviv Sourasky Medical Center, Tel-Aviv University, Tel-Aviv, Israel.
Institute of Oncology, Tel-Aviv Sourasky Medical Center, The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
J Surg Oncol. 2020 Dec;122(8):1655-1661. doi: 10.1002/jso.26178. Epub 2020 Aug 17.
Existing prognostic tools for retroperitoneal sarcomas (RPS) utilize parameters that can be accurately determined only postoperatively. This study evaluated the application of the neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) levels for predicting prognosis in primary RPS.
We retrospectively analyzed our database of patients with primary RPS operated between 2008 and 2018. The NLR was calculated from preoperative blood tests and its association with outcomes was determined.
The NLR values of 78 suitable patients were analyzed. Patients were classified in the NLR-high group if the NLR was ≥2.1. High-grade tumors were more common in the NLR-high group (71.6% vs 48%, P = .02). NLR-high patients had impaired overall survival (OS) and progression-free survival (PFS) compared to NLR-low patients (median OS not reached vs 74 months 95% confidence interval [CI]: 21.6-126.4, P = .03; median PFS not reached vs 48 months 95% CI: 6.5-98.6, P = .06, respectively). Multivariate analysis showed statistical significance only for PFS but not for OS (hazard ratio [HR] = 4.1, P = .03; HR = 2.3, P = .3). Patients with low CRP levels had improved OS and PFS.
The NLR may serve as a preoperative, easily derived marker for prognosis in RPS. Serum biomarkers may prove useful in these large and spatially heterogeneous tumors.
现有的腹膜后肉瘤（RPS）预后工具利用的是仅在术后才能准确确定的参数。本研究评估了中性粒细胞与淋巴细胞比值（NLR）和 C 反应蛋白（CRP）水平在预测原发性 RPS 预后中的应用。
我们回顾性分析了 2008 年至 2018 年间接受手术的原发性 RPS 患者的数据库。从术前血液检查中计算 NLR，并确定其与结果的相关性。
分析了 78 名合适患者的 NLR 值。如果 NLR≥2.1，则将患者分类为 NLR 高组。NLR 高组中更常见高级别肿瘤（71.6%比 48%，P=0.02）。与 NLR 低组相比，NLR 高组的总生存（OS）和无进展生存（PFS）较差（中位 OS 未达到比 74 个月 95%置信区间[CI]：21.6-126.4，P=0.03；中位 PFS 未达到比 48 个月 95%CI：6.5-98.6，P=0.06）。多变量分析仅显示 PFS 有统计学意义，但 OS 无统计学意义（危险比[HR]=4.1，P=0.03；HR=2.3，P=0.3）。CRP 水平低的患者 OS 和 PFS 改善。
NLR 可作为 RPS 预后的术前、易于获得的标志物。血清生物标志物在这些大而空间异质性的肿瘤中可能有用。
