Clinical significance of preoperative platelet count and platelet-to-lymphocyte ratio (PLT-PLR) in patients with surgically resected non-small cell lung cancer

Aim/Background

The aim of this study was to assess the prognostic significance of the preoperative platelet count (PLT) and platelet-to-lymphocyte ratio (PLR) in patients with surgically resected non-small-cell lung cancer (NSCLC).

Methods

We retrospectively reviewed 202 patients treated for NSCLC between January 2002 and December 2007. Preoperative PLT and PLR scores were calculated using data obtained at the time of admission. Patients were assigned a PLT-PLR score of 0, 1, or 2 based upon the presence of a high platelet count (> 450 × 10³/µL), an elevated PLR (> 160), or both.

Results

Patients with a PLT-PLR score of 2 had a significantly lower median overall survival rate(OS)[12.715mo;95% confidence interval (CI) 1.215-24.215] when compared with patients with PLT-PLR scores of 1(52.238mo;95% CI 17.062-87.414) or 0(p < 0.001). Relapse-free survival (RFS) was also significantly decreased in patients with PLT-PLR scores of 2(10.107mo;95% CI 3.388-16.826) relative to patients with PLT-PLR scores of 1(27.214mo;95% CI 0-56.253) or 0(58.893mo; 95% CI 32.938-84.848, p < 0.001). Moreover, in subgroup analyses of patients with squamous cell carcinoma histology, OS(p < 0.001) and RFS(p < 0.001) were significantly worse in the high risk group(PLT-PLR score of 2) than in the low risk(PLT-PLR score of 1 or 0). Multivariate analysis suggested that age ≥ 65[hazard ratio(HR) 1.666; 95% CI 1.090-2.545; p = 0.018], advanced disease(HR 1.903; 95% CI 1.145-3.162;p = 0.013), and PLT-PLR score of 2(HR 3.787;95% CI 1.986-7.220;p < 0.001) were all independent prognostic factors for poor OS.

Conclusions

Preoperative PLT-PLR scores can be useful for predicting disease prognosis in patients with surgically resected NSCLC. Further large prospective studies will be necessary to validate our findings.

Clinical trial identification

Disclosure

All authors have declared no conflicts of interest.