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Elevated neutrophil to lymphocyte ratio predicts poor prognosis in nasopharyngeal carcinoma

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Tumor Biology

Abstract

Elevated neutrophil to lymphocyte ratio (NLR) has been reported to be associated with worse survival in many malignancies, whereas its role in nasopharyngeal carcinoma (NPC) remains unclear. We retrospectively reviewed 363 consecutively, newly diagnosed, non-disseminated, and biopsy-proven NPC patients. Disease-specific survival (DSS), distant metastasis-free survival (DMFS), and locoregional recurrence-free survival (LRFS) rates were compared according to NLR level. Multivariate analysis was performed to assess the prognostic value of NLR. The 5-year DSS, DMFS, and LRFS rates for patients with elevated or non-elevated NLR (> or ≤3.73) were 59.6% vs. 76.6% (p = 0.03), 69.7% vs. 86.6% (p = 0.002), and 78.5% vs. 87.3% (p = 0.105), respectively. For patients with locoregionally advanced disease, NLR was not only an independent prognostic factor, but also a predictor of response to chemoradiotherapy. The 5-year DSS, DMFS, and LRFS rates for patients with elevated or non-elevated NLR were 47.2% vs. 73.7% (p < 0.001), 59.2% vs. 85.1% (p < 0.001), and 72.3% vs. 84.6% (p = 0.041), respectively. Compared with radiation alone, chemoradiotherapy significantly improved DSS and LRFS for patients with non-elevated NLR, but not for those with elevated NLR. Pre-treatment NLR is a strong prognostic factor for NPC patients. For patients with locoregionally advanced disease, NLR might also be a useful indicator for selection of treatment strategies.

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Authors and Affiliations

  1. State Key Laboratory of Oncology in South China, 651 Dongfeng East Road, Guangzhou, Guangdong, 510060, People’s Republic of China

    Xin An, Pei-Rong Ding, Feng-Hua Wang, Wen-Qi Jiang & Yu-Hong Li

  2. Department of Medical Oncology, Cancer Center, Sun Yat-sen Universisty, Guangzhou, Guangdong, 510060, People’s Republic of China

    Xin An, Feng-Hua Wang, Wen-Qi Jiang & Yu-Hong Li

  3. Department of Colorectal Surgery, Cancer Center, Sun Yat-sen Universisty, Guangzhou, Guangdong, 510060, People’s Republic of China

    Pei-Rong Ding

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  1. Xin An
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Correspondence to Yu-Hong Li.

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Xin An and Pei-Rong Ding contributed equally to this work.

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An, X., Ding, PR., Wang, FH. et al. Elevated neutrophil to lymphocyte ratio predicts poor prognosis in nasopharyngeal carcinoma. Tumor Biol. 32, 317–324 (2011). https://doi.org/10.1007/s13277-010-0124-7

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