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01.12.2013 | Translational Research and Biomarkers

Neutrophil:Lymphocyte Ratio and Intraoperative Use of Ketorolac or Diclofenac are Prognostic Factors in Different Cohorts of Patients Undergoing Breast, Lung, and Kidney Cancer Surgery

verfasst von: Patrice Forget, MD, Jean-Pascal Machiels, MD, PhD, Pierre G. Coulie, MD, PhD, Martine Berliere, MD, PhD, Alain J. Poncelet, MD, PhD, Bertrand Tombal, MD, PhD, Annabelle Stainier, MD, Catherine Legrand, PhD, Jean-Luc Canon, MD, Yann Kremer, MD, Marc De Kock, MD, PhD

Erschienen in: Annals of Surgical Oncology | Sonderheft 3/2013

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Abstract

Background

Inflammation is associated with a worse outcome in cancer and neutrophil:lymphocyte ratio (NLR) is a strong prognostic value. In cancer, nonsteroidal anti-inflammatory drugs (NSAIDs) could be of interest. We investigated the prognostic significance of NLR and the impact of intraoperative NSAIDs in cancer surgeries.

Methods

We performed an observational study in early breast, kidney, and lung cancers (357, 227, and 255 patients) with uni- and multivariate analyses (Cox model).

Results

In breast cancer (Centre 1), NLR ≥ 4 is associated with a higher risk of relapse (hazards ratio (HR) = 2.41; 95 % confidence interval (CI) 1.01–5.76; P = 0.048). In breast cancer (Centre 2), NLR ≥ 3 is associated with a higher risk of relapse (HR = 4.6; 95 % CI 1.09–19.1; P = 0.04) and higher mortality (HR = 4.0; 95 % CI 1.12–14.3; P = 0.03). In kidney cancer, NLR ≥ 5 is associated with a higher risk of relapse (HR = 1.63; 95 % CI 1.00–2.66; P = 0.05) and higher mortality (HR = 1.67; 95 % CI 1.0–2.81; P = 0.05). In lung cancer, NLR ≥ 5 is associated with higher mortality (HR = 1.45; 95 % CI 1.02–2.06; P = 0.04). The intraoperative use of NSAIDs in breast cancer patients (Centre 1) is associated with a reduced recurrence rate (HR = 0.17; 95 % CI 0.04–0.43; P = 0.0002) and a lower mortality (HR = 0.25; 95 % CI 1.08–0.75; P = 0.01). NSAIDs use at the beginning of the surgery is independently associated with a lower metastases risk after lung cancer surgery (HR = 0.16; 95 % CI 0.04–0.63; P = 0.009). Ketorolac use is independently associated with longer survival (HR = 0.55; 95 % CI 0.31–0.95; P = 0.03).

Conclusions

In these cohorts, these analyses show that NLR is a strong perioperative prognosis factor for breast, lung, and kidney cancers. In this context, intraoperative NSAIDs administration could be associated with a better outcome.

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Titel: Neutrophil:Lymphocyte Ratio and Intraoperative Use of Ketorolac or Diclofenac are Prognostic Factors in Different Cohorts of Patients Undergoing Breast, Lung, and Kidney Cancer Surgery
verfasst von: Patrice Forget, MD
Jean-Pascal Machiels, MD, PhD
Pierre G. Coulie, MD, PhD
Martine Berliere, MD, PhD
Alain J. Poncelet, MD, PhD
Bertrand Tombal, MD, PhD
Annabelle Stainier, MD
Catherine Legrand, PhD
Jean-Luc Canon, MD
Yann Kremer, MD
Marc De Kock, MD, PhD
Publikationsdatum: 01.12.2013
Verlag: Springer US
Erschienen in: Annals of Surgical Oncology / Ausgabe Sonderheft 3/2013
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-013-3136-x

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Neutrophil:Lymphocyte Ratio and Intraoperative Use of Ketorolac or Diclofenac are Prognostic Factors in Different Cohorts of Patients Undergoing Breast, Lung, and Kidney Cancer Surgery