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Gouji Toyokawa

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    EP1.03 - Biology (ID 193)

    • Event: WCLC 2019
    • Type: E-Poster Viewing in the Exhibit Hall
    • Track: Biology
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.03-25 - Impact of Preoperative Complete Blood Cell Count-Derived Inflammation Biomarkers in Early-Staged Non-Small Cell Lung Cancer Patients (Now Available) (ID 705)

      08:00 - 18:00  |  Author(s): Gouji Toyokawa

      • Abstract
      • Slides


      Although stage IA non–small-cell lung cancer (NSCLC) has an optimistic survival rate, up to 10% of these patients relapse after surgery and die. Inflammation plays a critical role in the development and progression of various cancers by promoting cancer cell proliferation and survival, angiogenesis and tumor metastases. Inflammatory cells in the tumor microenvironment significantly affect tumor development, and markers of systemic inflammation may indicate tumor status. In recent years, complete blood cell count (CBC)-derived inflammation biomarkers such as systemic immune-inflammation index (SII), neutrophils lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR) and monocyte lymphocyte ratio (MLR), are used as prognostic factors in various malignancies. These markers are based on two or three parameters selected among neutrophils, lymphocytes, platelets and monocytes. SII has been investigated as a prognostic factor in several malignancies. NLR, PLR and MLR have been used as markers as systemic inflammation and are associated with poor outcomes in sloid tumors. Concerning non-small cell lung cancer, these parameters have been also reported as poor indicators, but few have specifically studied stage IA disease. We retrospectively analyzed clinicopathological features of patients with stage IA NSCLC to identify recurrence predictors and to investigate effects of preoperative CBC-derived inflammation biomarkers.


      We selected 311 consecutive patients with stage IA NSCLC treated from April 2006 to December 2012 for this study, and tested their preoperative SII, NLR, PLR and MLR in uni- and multivariate Cox proportional analyses of recurrence free survival (RFS).


      Preoperative high MLR level was significantly associated with sex, smoking status, postoperative recurrence (P<0.0001, =0.0307 and =0.0146) and preoperative high SII level was only correlated with postoperative recurrence (P= 0.0458), although both NLR and PLR were not found any related factors. Intratumoral vascular invasion (P= 0.0412), intratumoral lymphatic invasion (P= 0.0097) and preoperative MLR level (P= 0.0269) were identified as independent predictors of shorter RFS. Relative risk for preoperative high MLR level patients was 2.259 compared with patients with low MLR level (95% CI: 1.094–5.000). 5-year RFS rate in preoperative high MLR group was significantly lower than that in low MLR group (82.21% vs. 92.05%, p=0.0062).

      2019wclc fig.jpg


      Preoperative MLR level is a simple and novel predictor of recurrence in patients with stage IA NSCLC.

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