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B. Yildirim



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    P3.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 214)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Locoregional Disease – NSCLC
    • Presentations: 1
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      P3.03-037 - High Pretreatment Neutrophil-Lymphocyte Ratio: A Poor Prognostic Factor for Stage III Non-Small Cell Lung Cancer Patients (ID 1034)

      09:30 - 09:30  |  Author(s): B. Yildirim

      • Abstract

      Background:
      Smoldering inflammation induced by tumor tissue form cytokine enrich environment which increase tumor growth potential significantly. Neutrophil-Lymphocyte ratio (N/L) has been reported as a valuable indicator for tumor induced systemic inflammation in literature. With this study, we aimed to evaluate potential prognostic role of pretreatment N/L ratio in locally advanced NSCLC patients those who were treated with curative chemoradiotherapy.

      Methods:
      Stage III 97 NSCLC patients were included into this study. Demographic characteristics of patients and well defined clinic and histopathological prognostic factors of their tumors were recorded. There is no clear delineated cut off value for N/L ratio in literature; first, we performed ROC curve statistical analysis. Our statistical analysis showed cut off level of 4.26 ED with high sensitivity and specifity. We used Kaplan-Meier survival curve and log-rank test (p<0.05) for survival analysis.

      Results:
      Figure 1 Median age was 58 years old (range 39-75), and 87 (89.7%) of the patients were men. ECOG performance score was 0-1 in 93 patients (95.9%). Squamous histology, most common histology, was diagnosed in 46 patients (47.4%). Number of Stage IIIA and IIIB patients 41(42.3%) and were 56 (57.7%), respectively. Objective response rate (CR+PR) and clinical benefit rate (CR+PR+SD) were 75.3% and 83.5%, respectively. Median follow-up time was 23.8 months (range 0.9-60). Median PFS and OS were 10.3 ([(95%CIs), 9.2-11.5) and 17.8 months ([(95%CIs), 11.4-24.4]. When we evaluate 61 (62.8%) patients those who relapsed, distant and local relapse rate were found as 57.1 and 42.9 %, respectively. When the patients were grouped through N/L ratio, below (group a) or upper (group b) the cut-off value (4.26 ED), there was a statistically significant difference between these groups, group a and group b, PFS and OS; 15.2 vs 8.1, 34 vs 23 months, respectively (p<0.005).



      Conclusion:
      Prognostic and predictive markers are major tools for oncologist to make decision making process. With this study, our results proved that pretreatment N/L ratio, marker for the systemic inflammation, may be used as a prognostic marker for the local advanced stage III NSCLC patients.