Category: Basic Science: Oncology
Introduction & Objective :
An elevated neutrophil-to-lymphocyte ratio (NLR) has been associated with adverse outcomes in various malignancies. However, its role in prognosticating testicular cancer is not fully validated. We aim to study the relationship between NLR and testicular cancer.
We retrospectively reviewed 160 patients with histological proven testicular cancer from January 2002 to Dec 2015. NLR was computed (median: 6 days) prior to surgery. NLR was analyzed as a continuous variable and a cut-off point of 3.0 was obtained, with a statistical receiver operating characteristics of 0.720. Chi-square, Kaplan-Meier curves and logistics regression models were used to predict NLR association with survival outcomes.
The median follow-up period was 7.8 years (range: 2.5 – 16.5). All 8 patients (0.5%) who died had metastatic disease. NLR ≥ 3.0 was independently associated with advanced pathological staging (T staging: p 0.031, HR 1.645, 95% CI 1.425 – 1.961; nodal disease: p<0.05, HR 6.239, 95% CI 3.043 – 12.794; metastatic disease p<0.05, HR 14.368, 95% CI 4.878 – 23.835). More importantly, patients with NLR ≥ 3.0 had a poorer 10 year overall survival of 87%, compared to 95% for patients with NLR <3.0 (p: 0.029, HR 5.996, 95% CI 1.803 – 24.886).
This study suggests that NLR can be an inexpensive novel factor in predicting advanced cancer staging and poorer survival outcome. This enables us to identify a group of patients with higher risk that may benefit from multimodal treatment, and closer surveillance to monitor long term survival.