Peripheral Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio as Prognostic Factors in Patients with Nasopharyngeal Carcinoma

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dr. Johan Kurnianda, Sp.PD-KHOM
dr. Agus Fitriyanto Achmad, sp.PD-KHOM
dr. Susanna Hilda Hutajulu, Ph.D, Sp.PD-KHOM


Background : This study aimed to evaluate the prognostic value of pretreatment peripheral neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in nasopharyngeal carcinoma (NPC).

Methods : A total of 450 NPC patients in Dr. Sardjito hospital, Yogyakarta were recruited. Kaplan-Meier was used to analyze patients’ survival while association of pretreatment NLR and PLR with overall survival (OS) were examined with Cox proportional hazards regression model (adjusted for age, gender, WHO pathological classification, clinical staging, and therapy).  

Results : Cut-off values of 5.35 and 339.23 for pretreatment NLR and PLR respectively were used to sort NPC patients into high- and low-level groups. NLR and PLR are associated with tumor size (P =0.015 : P =0.012). High NLR and PLR are significantly associated with lower OS (median OS±SE high-level NLR vs. Low-level NLR: 20.18 ± 2.68 vs. 33.29 ± 2.38 months, P< 0.001; median OS±SE high-level PLR vs. low-level PLR: 20.29 ± 1.89 vs. 32.86 ± 2.27 months, P< 0.001). NLR, clinical stage and therapy are independent prognostic factors in NPC (NLR: HR, 1.84; 95% CI, 1.26 – 2.7).

Conclusion : Pretreatment NLR is an independent prognostic factor and may serve as clinically useful biomarker for OS of NPC patients.

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