Predictive Significance of Inflammatory Markers in the Survival of Older Indian Patients with Cancer: a Single-center Prospective Analysis

Overview

Journal Ecancermedicalscience

Specialty Oncology

Date 2024 Oct 18

PMID 39421170

Authors

Abhijith Rajaram Rao

Vanita Noronha

Anant Ramaswamy

Anbarasan Sekar

Anita Kumar

Anupa Pillai

Shreya Gattani

Arshiya Sehgal

Sharath Kumar

Renita Castelino

Ratan Dhekale

Jyoti Krishnamurthy

Sarika Mahajan

Anuradha Daptardar

Lekhika Sonkusare

Jayita Deodhar

Nabila Ansari

Manjusha Vagal

Purabi Mahajan

Shivshankar Timmanpyati

Manjunath Nookala

Ankita Chitre

Akhil Kapoor

Vikram Gota

Shripad Banavali

Rajendra A Badwe

Kumar Prabhash

Affiliations

Soon will be listed here.

Abstract

Aim: To evaluate the prognostic impact of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and lymphocyte-monocyte ratio (LMR) on overall survival (OS) among Indian older patients with cancer.

Methods: This observational study was conducted in the geriatric oncology clinic of Tata Memorial Hospital (India). We included all patients who underwent a geriatric assessment (GA) and had a complete blood count available for analysis. The NLR was dichotomized at 3.5, PLR and LMR at the median. Our primary study outcome was OS.

Results: Between June 2018 and November 2021, 786 patients were enrolled (median age: 69 years). The most common primary tumour was lung (308, 39.5%), followed by gastrointestinal (261, 33.5%). Metastatic disease was present in 54.3% of patients. Univariate analysis revealed that patients with NLR >3.5 had shorter OS (9.1 months) than NLR <3.5 (15.7 months) (HR: 1.56). Similarly, patients with PLR >183.5 had reduced OS (9.3 months) compared to PLR <183.5 (16.6 months) (HR: 1.56). Conversely, patients with LMR >3.1 showed better OS (14.2) compared to LMR <3.1 (9.8 months) (HR: 0.74). After adjusting for age, performance status, primary tumour, metastatic status and GA-derived factors (function, nutrition and cognition), NLR (HR: 1.25, 95%CI: 1.03-1.52), PLR (HR: 1.34, 95%CI: 1.11-1.63) and LMR (HR: 0.79, 95%CI: 0.65-0.95) were associated with OS.

Conclusion: In our study of older cancer patients, we identified three key inflammatory markers (NLR >3.5, PLR >183.5, LMR <3.1) as strong predictors of poor OS. These markers remain predictive even after accounting for traditional prognostic factors and GA-derived scales.

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