Clinical significance of preoperative neutrophil–lymphocyte vs platelet–lymphocyte ratio in primary operable patients with non–small cell lung cancer

• Studies comparing prognostic value of NLR vs PLR in NSCLC have not been reported.
• This is one of the largest studies to evaluate the value of NLR and PLR in NSCLC.
• Our results indicated that NLR was superior to PLR as a predictive factor in NSCLC.
• As an indicator of survival in NSCLC, NLR should be considered for its clinical use.

BackgroundOur aim was to determinate the prognostic value of neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) in primary operable patients with non–small cell lung cancer (NSCLC).MethodsSix hundred seventy-eight NSCLC patients were enrolled in this study. The prognostic significance of both markers was determined by both univariate and multivariate Cox survival analysis. The cut-off value for NLR and PLR was selected by using receiver operating characteristic curve analysis.ResultsMultivariate analysis showed that NLR was an independent prognostic factor for disease-free survival (hazard ratio = 1.593, 95% confidence interval [CI] 1.277 to 1.988, P < .001) and overall survival (hazard ratio = 1.624, 95% CI 1.304 to 2.022, P < .001). The area under the curve was .640 (95% CI .599 to .682, P < .001) for NLR and .547 (95% CI .503 to .590, P = .036) for PLR, indicating that NLR was superior to PLR as a predictive factor in primary operable NSCLC patients.ConclusionsPreoperative NLR represents a significant independent prognostic indicator in primary operable NSCLC patients. Our results also demonstrate that high-risk patients based on the NLR do not benefit from adjuvant chemotherapy.