Preoperative inflammation-based scores predict early recurrence after lung cancer resection

被引:23
作者
Watanabe, Katsuya [1 ]
Noma, Daisuke [1 ,2 ]
Masuda, Haruhiko [1 ]
Masuda, Munetaka [3 ]
机构
[1] Natl Hosp Org Yokohama Med Ctr, Dept Gen Thorac Surg, Yokohama, Kanagawa, Japan
[2] Yokohamashi Nanbu Hosp, Dept Gen Thorac Surg, Yokohama, Kanagawa, Japan
[3] Yokohama City Univ, Dept Surg, Yokohama, Kanagawa, Japan
关键词
Non-small cell lung cancer (NSCLC); inflammation-based scores; hazard curve; recurrence; postoperative follow-up; GLASGOW PROGNOSTIC SCORE; RATIO PREDICTS; TUMOR; SURVIVAL; SURGERY; DYNAMICS;
D O I
10.21037/jtd-20-3458
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Background: Inflammation in the tumor microenvironment is hypothesized to have a major role in cancer invasiveness, progression, and metastases. The purpose of this study was to evaluate the prognostic value of preoperative inflammation-based scores in terms of estimating the timing of recurrence by hazard curves in a cohort of operable, early-stage non-small cell lung cancer (NSCLC) patients. Methods: A total of 387 patients with NSCLC who underwent complete pulmonary resection from 2010 to 2019 had their C-reactive protein-to-albumin ratio (CAR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), Glasgow prognostic score (GPS), modified GPS, systemic immune-inflammation index (SII), and advance lung cancer inflammation index (ALI) measurements taken before surgery. Hazard curves indicating changes in hazards over time were evaluated. Results: Median follow-up was 39.2 months. In total, 105 patients (27.1%) experienced recurrence. The resulting hazard curve with elevated CAR, SII, GPS, and mGPS, values displayed an initial high peak during the first year. Multivariate analyses showed that an elevated CAR [hazard ratio (HR), 1.987; 95% confidence interval (CI), 1.202-3.284] independently predicted the recurrence-free survival. Even in stage I disease, patients with elevated CAR and SII values showed an earlier peak of recurrence, which was about 12 to 16 months earlier than those with low values. Conclusions: Even after complete resection of stage I NSCLC, patients with elevated CAR and SII values retain a high risk of early recurrence. Preoperative inflammation-based scores can be an objective, simple, and cost-effective measurement for predicting early recurrence of NSCLC.
引用
收藏
页码:2812 / 2823
页数:12
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