Evidence map›Paper›PMID 34138894›Full record

ArticlePloS one2021

Comparison of neutrophil to lymphocyte ratio and prognostic nutritional index with other clinical and molecular biomarkers for prediction of glioblastoma multiforme outcome.

Celine Garrett, Therese M Becker, David Lynch, Joseph Po, Wei Xuan, Kieran F Scott, Paul de Souza

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In one paragraph

Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Celine GarrettSchool of Medicine, Western Sydney University, Campbelltown, NSW, Australia.ORCID 0000-0002-7255-6580
Therese M BeckerSchool of Medicine, Western Sydney University, Campbelltown, NSW, Australia.
David LynchSchool of Medicine, Western Sydney University, Campbelltown, NSW, Australia.
Joseph PoCirculating Tumour Cells Group, Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.
Wei XuanCirculating Tumour Cells Group, Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.
Kieran F ScottSchool of Medicine, Western Sydney University, Campbelltown, NSW, Australia.ORCID 0000-0002-6012-4107
Paul de SouzaSchool of Medicine, Western Sydney University, Campbelltown, NSW, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivePre- and post-operative neutrophil to lymphocyte ratio (NLR) and prognostic nutritional index (PNI) and other prognostic clinicopathological variables were correlated with progression free survival (PFS) and overall survival (OS) of Glioblastoma Multiforme (GBM) patients.

methodsGBM patients (n = 87, single-centre, recruited 2013-2019) were retrospectively divided into low and high groups using literature-derived cut-offs (NLR = 5.07, PNI = 46.97). Kaplan-Meier survival curves and log rank tests assessed PFS and OS. Univariate and multivariate analyses identified PFS and OS prognosticators.

resultsHigh vs low post-operative PNI cohort was associated with longer PFS (279 vs 136 days, p = 0.009), but significance was lost on multivariate analysis. Post-operative ECOG (p = 0.043), daily dexamethasone (p = 0.023) and IDH mutation (p = 0.046) were significant on multivariate analysis for PFS. High pre- and post-operative PNI were associated with improved OS (384 vs 114 days, p = 0.034 and 516 vs 245 days, p = 0.001, respectively). Low postoperative NLR correlated with OS (408 vs 249 days, p = 0.029). On multivariate analysis using forward selection process, extent of resection (EOR) (GTR vs biopsy, p = 0.004 and STR vs biopsy, p = 0.011), and any previous surgery (p = 0.014) were independent prognostic biomarkers for OS. On multivariate analysis of these latter variables with literature-derived prognostic biomarkers, EOR remained significantly associated with OS (p = 0.037).

conclusionsEOR, followed by having any surgery prior to GBM, are the most significant independent predictors of GBM patient's OS. Post-operative ECOG, daily dexamethasone and IDH mutation are independent prognostic biomarkers for PFS. PNI may be superior to NLR. Post- vs pre-operative serum inflammatory marker levels may be associated with survival.

Indexed as

Nutritional StatusAgedBiomarkers, TumorBrain NeoplasmsDexamethasoneFemaleGlioblastomaHumansIsocitrate DehydrogenaseKaplan-Meier EstimateLymphocytesMaleMiddle AgedMultivariate AnalysisMutationNeutrophilsBiomarkers, TumorDexamethasoneIsocitrate Dehydrogenase

Identifiers

PMID34138894
PMCPMC8211244

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.