Abstract 3951
Background
Neutrophil-lymphocyte ratio (NLR) is a predictive factor of survival in cancer, probably as a biomarker of systemic inflammation, but with limited evidence in neuroendocrine neoplasms (NENs). NENs are a very heterogeneous disease with a large range of survival from few months to many years. Stage, grade and primary tumor location are known prognostic factors, but still limited. New prognostic biomarkers are needed. The aim of this study is to evaluate the association between NRL and survival (OS) in neuroendocrine neoplasms.
Methods
Data from patients diagnosed with extra-pulmonary neuroendocrine neoplasms (Grade 1 to 3) from a Portuguese tertiary cancer center were reviewed retrospectively (January 00 - March 19). NLR was calculated at diagnosis as the ratio between neutrophils and lymphocytes.
Results
In our cohort, 116 patients were identified (52% male; median age 62yo (IQR 33-80) with neuroendocrine neoplasms: 76 gastroenteropancreatic (GEP), 32 unknown primary (UP) and 8 from other primary tumor location. 54 patients were G1/G2 and 51 patients were G3/NEC. 5year OS was different according to grade [79% (IC95% 68-91%) for G1/G2 tumors and 16% (IC95% 7-35%) for G3/NEC (p < 0.001)] and to primary tumor location [62% (95%CI 51-76%) for GEP and 15% (95%CI 6-34%) for UP (p < 0.001)]. NLR analysis started by determination of NLR median in this cohort: 2.526 (IQR 1.690-3.681). Patients were then divided in two groups: low NLR (< 2.526) and high NLR (≥2.526). 5year OS according to NLR was significantly different: 58% (IC95% 46-73%) for low NLR and 33% (ICD95% 22-49%) for high NLR (p = 0.038). After stratification by grade and primary tumor location, influence of NLR categories remains, patients with high NLR had a poor OS comparing to patients with low NLR (HR = 1.87, 95%CI 1.00-3.49, p = 0.05). A non-categorical analysis of NLR, stratified by grade and primary tumor location, showed that the risk of death increases 17% by each 1 unit rise in NLR (HR = 1.17, 95%CI 1.08-1.27, p = 0.0002).
Conclusions
Our study showed that NRL is an independent prognostic factor in survival in neuroendocrine neoplasms. Further studies are needed to evaluate the prognostic value of NLR as well as to evaluate its ability to predict response to different therapies.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
4653 - Impact of Pembrolizumab (pembro) Versus Paclitaxel on Health-Related Quality of Life (HRQoL) in Patients With Advanced Gastric or Gastroesophageal Junction (GEJ) Cancer That Has Progressed After First-Line Chemotherapy (KEYNOTE-061)
Presenter: Eric Van Cutsem
Session: Poster Display session 2
Resources:
Abstract
5063 - Does Nutritional Status Affect Treatment Tolarability, Response and Survival in Metastatic Gastric Cancer Patients? Results of Prospective Multicenter Study
Presenter: Senem Karabulut
Session: Poster Display session 2
Resources:
Abstract
2717 - Ramucirumab use in patients with Advanced Gastric Cancer (AGC) or gastro-oesophageal junction (GEJ) adenocarcinoma in Spain: RAMIS observational study
Presenter: Federico Longo Munoz
Session: Poster Display session 2
Resources:
Abstract
3187 - Gastrectomy plus chemotherapy versus chemotherapy alone for advanced gastric cancer with a single non-curable factor: Exploratory analysis in the patients who were enrolled in JCOG0705/KGCA01 phase III trial (REGATTA) and could continue chemotherapy
Presenter: Takaki Yoshikawa
Session: Poster Display session 2
Resources:
Abstract
4765 - A prospective observational study on the optimal maintenance strategy in HER2-positive advanced gastric cancer treated with trastuzumab based therapy
Presenter: Qian Li
Session: Poster Display session 2
Resources:
Abstract
3500 - Randomised phase 2 trial of first-line docetaxel, carboplatin, capecitabine (CTX) and epirubicin, oxaliplatin, capecitabine (EOX) in advanced esophagogastric adenocarcinoma (SEED)
Presenter: Peter Petersen
Session: Poster Display session 2
Resources:
Abstract
5197 - Ramucirumab in the treatment of refractory metastatic gastric cancer: results from the RamSelGa trial.
Presenter: Alexey Tryakin
Session: Poster Display session 2
Resources:
Abstract
2011 - Regorafenib in combination with Paclitaxel for beyond first-line treatment of advanced esophagogastric cancer (REPEAT): a phase Ib trial with expansion cohort
Presenter: Mohammed Khurshed
Session: Poster Display session 2
Resources:
Abstract
2117 - The relationship between the survival and fixed dosing of S-1 in advanced gastric cancer patients by pooled analysis using individual data from four Japanese randomized phase III trials
Presenter: Wataru Ichikawa
Session: Poster Display session 2
Resources:
Abstract
2669 - A Phase 1b Study of Oraxol in Combination with Ramucirumab in Patients with Gastric or Esophageal Cancers who failed previous chemotherapy
Presenter: Ming Huang Chen
Session: Poster Display session 2
Resources:
Abstract