Prognostic significance of novel inflammatory markers in extensive-stage small-cell lung cancer

Objective: Novel hematological inflammation-based parameters, such as neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), prognostic nutritional index (PNI), lymphocyte-to-C-reactive protein ratio (LCR), systemic inflammatory response index (SIRI), and hemoglobin-to-red cell distribution width ratio (HRR), have been determined to be linked to prognosis of various cancer types, although the predictive impact of these parameters on extensive-stage small-cell lung cancer (SCLC) is not exactly known. In this study, we aimed to demonstrate the prognostic significance of these novel parameters. Materials and Methods: This retrospective study included 162 patients who were under follow-up with a diagnosis of extensive-stage SCLC. The receiver operating characteristic curve analysis revealed that the optimal cutoff values for NLR, SII, PNI, LCR, SIRI, and HRR were 2.34, 787, 46.13, 0.29, 1.5, and 1.05, respectively. Cox regression analyses were done to determine the predictive impact of these parameters on progression-free survival (PFS) and overall survival (OS). Results: Patients with higher LCRs and HRRs had longer PFS and OS than patients with lower LCRs and HRRs (P < 0.001, P < 0.001, P < 0.001, P < 0.001, respectively). PFS and OS were significantly shorter in the group with high SIRIs than in the group with low SIRIs (P < 0.001, P < 0.001, respectively). A multivariate analysis identified LCR and SIRI as independent prognosticators for both PFS and OS (P < 0.001, P < 0.001; P = 0.002, P < 0.001, respectively), and HRR as an independent prognostic factor only for OS (P = 0.046). Conclusion: LCR, SIRI, and HRR are independent prognostic parameters that predict survival times in patients with extensive-stage SCLC.