ArticleIn vivo (Athens, Greece)
Pan-cancer Evaluation of the Neutrophil-to-Lymphocyte Ratio as a Prognostic Marker Across Six Major Solid Tumors.
Article in In vivo (Athens, Greece). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND/
aimSystemic inflammation is increasingly recognized as a key hallmark of cancer progression and an important determinant of patient outcomes, reflecting the balance between tumor-promoting inflammatory activity and anti-tumor immune competence. Using routinely available peripheral blood counts, we evaluated the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) across several common malignancies and developed a pragmatic model for overall survival risk estimation. PATIENTS AND
methodsFrom the INSCOC registry, 14,425 patients with lung, gastric, colorectal, liver, brain, or breast cancer were included and randomly split (10,098/4,327) into training and validation sets. Six inflammation-based indices from neutrophil, lymphocyte, and platelet counts were compared for overall survival (OS) using Harrell's C-index and time-dependent receiver operating characteristic (ROC) curves. Associations between NLR and OS were tested by Kaplan-Meier curves, restricted cubic splines, and multivariable Cox models adjusted for demographic, clinical, and treatment factors. A nomogram incorporating NLR and selected routinely available clinical variables was developed and internally evaluated by calibration analysis.
resultsNLR showed the highest, though modest, discrimination across all six cancers (C-index ~0.53-0.63). A threshold of 3.38 identified patients with significantly shorter OS in both sets (log-rank
conclusionElevated NLR independently signals worse survival across several major solid tumors and showed higher prognostic discrimination than other evaluated inflammation-derived indices. The proposed nomogram may provide a simple, clinically applicable tool to support individualized risk stratification using routinely available data.
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