Prognostic Factors Determining Survival of Patients Operated for Non-Small Cell Lung Cancer with Consideration Given to Morphological Parameters of Blood
Authors Łochowski M, Łochowska B, Chałubińska-Fendler J, Zawadzka I, Rębowski M, Kozak J
Received 3 September 2020
Accepted for publication 28 November 2020
Published 18 January 2021 Volume 2021:13 Pages 479—487
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Ahmet Emre Eşkazan
Mariusz Łochowski,1 Barbara Łochowska,2 Justyna Chałubińska-Fendler,3 Izabela Zawadzka,4 Marek Rębowski,1 Józef Kozak1
1Clinic of Thoracic Surgery and Respiratory Rehabilitation, Medical University of Lodz, Regional Multi-Specialist Center for Oncology and Traumatology of the Nicolaus Copernicus Memorial Hospital in Lodz, Lodz, Poland; 2Department of Radiotherapy and General Oncology, Regional Multi-Specialist Center for Oncology and Traumatology of the Nicolaus Copernicus Memorial Hospital in Lodz, Lodz, Poland; 3Department of Radiotherapy, Military Institute of Medicine, Warsaw, Poland; 4“Synevo” Medical Laboratory, Regional Multi-Specialist Center for Oncology and Traumatology of the Nicolaus Copernicus Memorial Hospital in Lodz, Lodz, Poland
Correspondence: Mariusz Łochowski
Department of Thoracic Surgery, Medical University of Lodz, Ul. Pabianicka 62, Lodz 93-513, Poland
Tel +48 42 689 52 31
Introduction: Prognostic biomarkers are the area of high interest in non-small cell lung cancer (NSCLC). Inflammatory blood markers can be routinely determined from complete blood counts which are inexpensive and reliable. The aim of the study was to determine prognostic parameters which, in early diagnostics, best determine survival of patients, operated on due to NSCLC.
Materials: The study was conducted on 532 (174 females and 358 males) patients, operated on due to NSCLC, in stages IA – III, aged 36– 84 years (the mean age: 63.6 years). The following parameters were subjected to a statistical analysis, conducted in order to determine prognostic values of the number of leukocytes, neutrophils, monocytes, platelets, haemoglobin, RDW-CV and MCV, calculated values of PLR, NLR, and LMR ratios, age, sex, smoking, histopathological diagnosis, T stage, N stage, the Charlson Comorbidity Index (CCI), type of surgery, and potential complications.
Results: The univariate analysis revealed an impact of NLR, PLR, and LMR values, RDW-CW and CCI ranges, and also the number of monocytes on patients’ overall survival (OS). The multivariate analysis identified six independent negative prognostic factors: male sex (0.001), CCI > 4 (p=0.000007), RDW-CV > 14.5% and PLR > 144 (p=0.000001, p= 0.001, respectively), the number of metastatic N2 lymphatic nodes (p=0.0003), and existence of post-operative complications (p=0.008).
Conclusion: Patients’ sex, RDW and PLR values, Charlson index, the number of involved N2 nodes by cancer and postoperative complications are independent and significant prognostic factors in patients operated on due to NSCLC.
Keywords: carcinoma, non-small cell, comorbidity index, red cell distribution width, platelets, lymphocytes
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