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Mario Montesinos



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    EP1.03 - Biology (ID 193)

    • Event: WCLC 2019
    • Type: E-Poster Viewing in the Exhibit Hall
    • Track: Biology
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.03-04 - Analysis of Post-Surgical Systemic Inflammatory Indexes After Non-Small Cell Lung Cancer Surgical Intervention (ID 1135)

      08:00 - 18:00  |  Author(s): Mario Montesinos

      • Abstract
      • Slides

      Background

      High NSCLC´s mortality rates pushes the research of new prognostic indexes further tan TNM staging and could help in better treatment´s selection. Neutrophil-Lymphocyte Ratio (NLR) preoperatively determined has demonstrated its relation with the immunologic status of the patient prior to the intervention and its capacity of “beating” tumor growing and its prognostic influence.

      OBJECTIVE: Evaluate the prognosis influence of NLR, Lymphocyte-Monocyte Ratio (LMR) and Platelet-Lymphocyte Ratio (PLR) in patients who underwent surgery for NSCLC with R0 resection and abscence of neoadjuvant treatment in peripheric blood determinations after surgery.

      Method

      A retrospective review of all consecutive patients operated on stage I to IIIA NSCLC from may 2014 – october 2018, completely resected and with no neoadjuvant treatment. Patients with previous oncologic history, haematologic neoplasms, perioperatory blood transfussion, perioperative infections or corticosteroids treatment were excluded. Peripheral blood determinations were taken during the first 6-months follow-up period.

      NLR, LMR and PLR were calculated.

      A descriptive analysis of demographic, tumor and surgical details is done.
      Overall survival (OS) was calculated since the date of surgery to date of death or last follow-up date. Disease-free survival (DFS) was calculated since the date of surgery to the date of recurrence. The discrimination capacity of the ratios was assessed with the calculation of the area under the ROC curve [AUC (CI 95%)].

      The relationship among relevant clinico-pathological variables, DFS and OS was calculated. Analysis of recurrence risk factors with univariate and multivariate binary logistic regression (LR) OR(95%CI) was performed.

      Result

      86 patients were included in the analysis. Median follow-up time was 45.7 months. Median OS and DFS were 27 and 24 months respectively. The AUC values of NLR [0.59(0,44-0,74)] and PLR [0,61(0,45-0,76] were not statistically significant, but value of LMR was significant with [0,70(0,57-0,83)].

      The LR model found as factors associated with a higher probability of recurrence adjusted by sex and age: the value of LMR with OR=0,38 (0,20-0,73) and a higher stage than the OR=11,3 (1,89-67.5).

      Conclusion

      Conversely to other publications, in our study the results showed the only relationship between LMR, tumor stage and risk of recurrence.

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    P1.03 - Biology (ID 161)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Biology
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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      P1.03-43 - Preoperative Prognostic Value of Immune-Inflammation Index in Patients with Operable Non-Small Cell Lung Cancer (Now Available) (ID 50)

      09:45 - 18:00  |  Author(s): Mario Montesinos

      • Abstract
      • Slides

      Background

      There is increasing evidence that the systemic immune-inflammation response is correlated with clinical outcomes in diverse solid tumors. The aim of the study was to determine preoperative values of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and lymphocyte to monocyte ratio (LMR), and to analyze their impact on histologic outcomes and prognosis in patients with operable non-small cell lung cancer (NSCLC).

      Method

      Retrospective study of patients diagnosed of stage I-IIIA NSCLC (7th edition TNM) between May 2014 and October 2018. Exclusion criteria included neoadyuvant therapy, R1-R2 resection, previous autoimmune or hematological disorders, active pre- or postoperative infection, steroid therapy, perioperative blood transfusion and previous history of malignancy other than NSCLC. The NRL, PLR and LMR were calculated by means of a peripherical blood sample 4 weeks prior to surgery. Receiver operating characteristic (ROC) curve was used to determine the optimal cut-off values for above mentioned ratios. The association between NRL, PLR and LMR, and histological outcomes, recurrence, disease free interval (DFI) and overall survival were analyzed.

      Result

      Eighty-six patients who underwent surgery for NSCLC were included in this retrospective analysis (51% males, median age 69,5 years). Mean follow-up was 45,7 months. Median overall survival and DFI were 27 and 24 months respectively. There was no statistically significant association between PLR, MLR, and histological variables, DFI or overall survival. The optimal cut-off value was 1.90 for NLR. In our series, INR values superior to 1.90 showed a significantly higher recurrence rate (23.6% vs. 5.5%, p=0.04) (Fig. 1) and a decreased overall survival (90% vs. 97%, p=0.031).

      graphic1.jpg

      Conclusion

      This study demonstrated that NLR is an independent poor outcome marker for patients with I-IIIA NSCLC who underwent surgery. In our series NLR (cut off value >1.90) could be used preoperatively as a valuable prognostic marker for disease free interval and overall survival.

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