Abstract 1070P
Background
Despite many advances in cancer treatment during last decades, cancer of unknown primary (CUP) remains one of the most difficult to manage, with a poor median survival ranging between 6-10 months. Identification of a new predictor could contribute to a better understanding of this disease and a proper patient’s treatment selection. The neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation related to disease progression in many types of cancer. Therefore, we decided to evaluate the predictive value of this biomarker in patients with cancers of unknown primary.
Methods
A total of 143 CUP patients treated at a single tertiary cancer center between 04.2006 to 11.2016 were analyzed. Patient clinical and demographical pretreatment data that might have influenced the outcome were collected. Univariate and multivariate survival analyses were used to predict overall survival (OS). The independent effect of NRL was confirmed by multivariate Cox proportional hazards regression.
Results
Median NLR was 3.76 (range 0.76-33.19). We dichotomized the study population into high NLR (>3.76) and low NLR (<3.76) groups. Median survival (in months) among low NLR patients was 11.7 versus 3.97 among high NLR patients, with 3 year-survival-rates 19.4% and 1.49% respectively (p<0,001). After adjusting for other factors that might affect the survival prognosis (using Cox multivariate analysis) high NLR remained to be an independent significant predictor of unfavorable outcome (hazard ratio (HR): 2.56, 95% confidence interval (CI): 1,71-3,83).
Conclusions
High neutrophil-to-lymphocyte ratio is an independent predictor for overall survival in patients with cancers of unknown primary. NLR is a low cost, easily accessible and compelling biomarker that requires further prospective assessment to determine other benefits of use.
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.