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Carlos Vallejos
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P2.16 - Treatment in the Real World - Support, Survivorship, Systems Research (ID 187)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Treatment in the Real World - Support, Survivorship, Systems Research
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.16-24 - Prognostic Value of RDW, NLR and CYFRA 21-1 in Overall Survival of Patients with Metastatic NSCLC (Now Available) (ID 2783)
10:15 - 18:15 | Author(s): Carlos Vallejos
- Abstract
Background
Lung cancer remains as the main cause of death in many regions around the world. Unfortunately, most cases are diagnosed as advanced disease that determinates dismal outcomes. There is a lack of biomarkers in clinical practice and also high mortality rates not related to cancer. CYFRA 21-1 is an important biomarker related to burden of disease; neutrophils-to-lymphocyte ratio (NLR) and red blood call distribution width (RDW) represent systemic inflammatory biomarkers indirectly related to immune response, and nutritional components, which are critical factors that can increase the risk of death not related to cancer. Our aim was to evaluate the prognosis value of CYFRA 21-1, NLR, RDW and components of nutritional status (albumin, creatinine, and hemoglobin) in overall survival (OS) of metastatic NSCLC patients treated at a private institution (Oncosalud - AUNA).
Method
We analyzed data of 87 patients with metastatic NSCLC treated at Oncosalud-AUNA 2011 - 2014 (Lima - Peru). The clinical-pathological data were collected from digital medical records. The laboratory data (hemoglobin, albumin, RDW-CV, creatinine, neutrophil, lymphocyte, and monocyte) and CYFRA 21.1 were collected from blood routine tests. Optimal cutoff value of NLR (<3.6 and >3.6), LMR (<4.7 and >4.7), RDW-CV (<15% and >15%) and CYFRA 21.2 (<3.3 and >3.3) were determinate using the maximally selected rank statistics. OS was determinate using Kaplan-Meier method and survival curves comparison were performed using log-rank or Breslow test. Cox model was used to estimate the effect of nutritional components and tumoral biomarkers on overall survival.
Result
The median age was 68 years (range: 40-84) and 50.6% of cases were women. The 26.4% presented with 2-4 ECOG scale, the most frequent site of metastasis were bone (36%) and brain (22%), and the most common histology was adenocarcinoma (84%). Hemoglobin was low in 16% and 28.7% had abnormal albumin, 44.8% elevated RDW-CV, 24.1% abnormal creatinine, 47.1% elevated NLR, and 72.4% high CYFRA 21-1 value. The 88.5% of patients received chemotherapy and 11.5% had TKI as first-line treatment. The median follow-up was 60 months (95%CI: 44.4-74.6), median survival was 13.2 months (95%CI: 9.8 - 16.7), two and 5-years survival rate were 30.8% and 17.1%, respectively. In univariate analysis, only ³2 ECOG scale (p = 0.062), RDW-CV >15 (p = 0.011), NLR >3.6 (p = 0.019) and CYFRA 21.1 >3.3 ng/mL (p = 0.003) were associated with poor survival. We did not found significant differences with age, sex, Hb, albumin, and LMR. In the Cox model, low values of Hb (HR: 2.1, 95%CI: 1.01-4.5), high values of RDW-CV (HR: 2.6, 95% CI: 1.3 - 5.2), NLR (HR: 1.8, 95% CI: 1.1 – 3.2) and CYFRA21.2 (HR: 2.3, 95% CI: 1.1 - 4.6) were associated with poor OS.
Conclusion
Overall survival for our patients was similar to reports from other series. Patients with elevated RDW, NLR and CYFRA 21.2 have poor prognostic in our cohort.
