Abstract 1647P
Background
Across many different tumors, there is increasing evidence that systemic inflammatory response is an independent prognostic factor. Poor survival in cancer patients has been associated with high baseline values of NLR and PLR. High LMR has been associated with better outcomes. The prognostic implications of NLR, PLR and LMR are not well described in osteosarcoma. The purpose of this study is to examine the prognostic value of NLR, PLR and LMR in conventional osteosarcoma (CO), non-osteogenic bone sarcoma (NOBS) and extraskeletal osteosarcoma (ESOS).
Methods
Pts who underwent potentially curative surgery for osteosarcoma from 2000-2018 were identified from a prospectively maintained database within our program. Pts with CO, NOBS and ESOS were included. Baseline NLR, PLR and LMR were calculated from blood sample taken prior to treatment. Optimal cut-off values of NLR 3.9, PLR 222 and LMR 2.2 in predicting OS & disease-free survival (DFS) were determined based on ROC curve analyses. Survival were calculated using the Kaplan-Meier method.
Results
Three hundred and seventy pts were identified, comprising of CO (n=240; 65%), NOBS (n=94; 25%) and ESOS (n=36; 10%). Fifty-eight percent of pts were males with median age of 40. Most pts presented with tumors affecting the limbs (79%). Forty-eight percent of pts were still alive without disease at time of evaluation, with a median follow up 183 months. In a univariate analysis, high PLR was associated with inferior OS in CO (5 yr OS 47% vs 64%, p=0.031) and in all pts (5 yr OS 46% vs 65%, p=0.039). High LMR was associated with better OS in NOBS (5 yr OS 56% vs 26%, p=0.016) and in all pts (5 yr OS 68% vs 42%, p=0.012). NLR cut off did not reach statistical significance to predict OS. Neither NLR, PLR nor LMR predict DFS, regardless of population. Analysis of pts with low NLR, low PLR and high LMR demonstrated a strong association with pts who had >90% necrotic rate (p<0.0001).
Conclusions
Our results suggest that high PLR and low LMR are associated with a worse outcome in osteosarcoma pts and is correlated with tumor necrosis rate at resection. Further work is needed to validate its use as a prognostic tool in sarcoma population.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Toronto Sarcoma Program.
Funding
Has not received any funding.
Disclosure
A. Abdul Razak: Advisory/Consultancy, Research grant/Funding (institution): Lilly; Advisory/Consultancy, Research grant/Funding (institution): Boehringer Ingelheim; Advisory/Consultancy, Research grant/Funding (institution): Merck. All other authors have declared no conflicts of interest.