J Cancer 2018; 9(12):2132-2139. doi:10.7150/jca.24871

Research Paper

Combined Use of the Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratios as a Prognostic Predictor in Patients with Operable Soft Tissue Sarcoma

Yao Liang1,2*, Wei Wang1,2*, Jingjing Li1,3*, Yuanxiang Guan1,2, Yi Que1,3, Wei Xiao1,3*, Xing Zhang1,3✉, Zhiwei Zhou1,2✉

1. State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China;
2. Department of Gastric Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China;
3. Department of Medical Melanoma and Sarcoma, Sun Yat-sen University Cancer Center, Guangzhou, China
* These authors contributed equally to this article

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Citation:
Liang Y, Wang W, Li J, Guan Y, Que Y, Xiao W, Zhang X, Zhou Z. Combined Use of the Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratios as a Prognostic Predictor in Patients with Operable Soft Tissue Sarcoma. J Cancer 2018; 9(12):2132-2139. doi:10.7150/jca.24871. Available from http://www.jcancer.org/v09p2132.htm

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Abstract

Background: Preoperative neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are associated with poor prognosis in soft tissue sarcoma (STS). The aim of the present study is to determine whether the combination of NLR and PLR (CNP) can better predict patient survival after resection for STS.

Methods: We included 310 STS patients in this retrospective study. Preoperative CNP was calculated as follows: patients with both elevated NLR (>2.51) and PLR (>191.1) were given a score of 2; patients showing an increase in one or neither were allocated a score of 1 or 0, respectively.

Results: Cut-off values of 2.51 and 191.1 were defined as elevated NLR and PLR, respectively. Elevated CNP was significantly associated with older age (P=0.034), larger tumor size (P=0.025), deeper tumor location (P=0.044), higher tumor grade (P=0.028), a more advanced stage according to the American Joint Committee on Cancer (AJCC) (P=0.005), shorter overall survival (OS) (P=0.000) and shorter disease-free survival (DFS) (P=0.000). Multivariate analysis indicated CNP but not NLR or PLR to be an independent prognostic factor for OS and DFS (P=0.000 and P=0.001, respectively).

Conclusions: Preoperative CNP is associated with tumor progression and can be considered an independent marker of postoperative survival in patients with STS.

Keywords: Soft tissue sarcoma, NLR, PLR, Prognostic factor, Survival