Neutrophill-lymphocyte ratio predicts survival in patients with advanced cholangiocarcinoma on chemotherapy
- Affiliated Author(s)
- 이윤석
- Alternative Author(s)
- Lee, Yoon Suk
- Journal Title
- Cancer Immunology, Immunotherapy
- ISSN
- 0340-7004
- Issued Date
- 2016
- Keyword
- Neutrophil–lymphocyte ratio; Cholangiocarcinoma; Chemotherapy; Prognostic factor; Survival
- Abstract
- The blood neutrophil-to-lymphocyte ratio (NLR)
is reported to be a prognostic marker in several cancers. However,
the prognostic role of NLR in patients with advanced
cholangiocarcinoma on chemotherapy is unknown. A total of
221 patients with pathologically confirmed locally advanced
or metastatic cholangiocarcinoma receiving first-line palliative
chemotherapy were enrolled. Associations between
baseline clinical and laboratory variables including NLR and
survival were investigated. Patients were classified into two
groups according to the NLR level (≤5 vs. >5). Median overall
survival (OS) and time to progression (TTP) in patients
with NLR ≤ 5 were 10.9 and 6.7 months, respectively, and
6.8 and 4.1 months in patients with NLR > 5 (P < 0.001,
P = 0.002, respectively). In multivariate analysis, number of
cycles of chemotherapy was a significant predictor of longer OS (HR 0.86, P < 0.001), whereas adverse prognostic factors
for OS were CA 19-9 > 300 (HR 1.43, P = 0.025), CEA > 5
(HR 1.44, P = 0.029), higher stage (HR 1.69, P = 0.004),
and NLR > 5 (HR 1.87, P < 0.001). NLR > 5 was also associated
with reduced TTP (HR 1.66, P = 0.007). Among 50
patients with initial NLR > 5, 33 patients had NLR ≤ 5 after
two cycles of chemotherapy and they had significantly better
survival than the others (HR 0.48, P = 0.015). NLR independently
predicts survival in patients with advanced cholangiocarcinoma
undergoing chemotherapy. Considering costeffectiveness
and easy availability, NLR may be a useful
biomarker for prognosis prediction.
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