Preoperative lymphocyte count is a favorable prognostic factor of disease-free survival in non-small-cell lung cancer
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ORIGINAL PAPER
Preoperative lymphocyte count is a favorable prognostic factor of disease-free survival in non-small-cell lung cancer Jian Zhang • Shao-Hong Huang • Hui Li • Yun Li • Xiu-Ling Chen • Wei-Qing Zhang Hui-Guo Chen • Li-Jia Gu
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Received: 14 July 2012 / Accepted: 2 August 2012 Ó Springer Science+Business Media New York 2012
Abstract Recently, the prognostic value of cancer-related inflammatory response has been revealed. Previous studies showed that peripheral neutrophils and lymphocytes had significant impact on the prognosis of advanced and early-node-negative non-small-cell lung cancer (NSCLC). The purpose of this study was to investigate the prognostic value of preoperative lymphocyte and neutrophil counts in patients with NSCLC who underwent lobectomy and lymph node dissection and adjuvant chemotherapy. Retrospective analyses were performed to examine the impact of preoperative peripheral lymphocyte and neutrophil counts on disease-free survival (DFS) and overall survival (OS) and to analyze the relationships of these factors to clinicopathological factors. A total of 142 patients with NSCLC were evaluated of which 57 (40.1 %) patients had local recurrence or metastasis. Multivariate analyses revealed that peripheral lymphocyte count was an independent favorable prognostic factor of DFS (hazard ratio 0.548; 95 % confidence interval 0.351–0.857; P = 0.008) but not OS (P = 0.164). The maximum logrank statistical value was 9.504 (P = 0.002) when the cutoff value of lymphocyte was 1,800 mm-3. The median DFS was 318.0 days (95 % confidence interval 226.0–410.0) for lymphocyte B1,800 mm-3 group and 669.0 days (95 % confidence interval 0.0–1,431.0) for lymphocyte [1,800 mm-3 group. Low lymphocyte count was related with lymphatic invasion (P = 0.012) and recurrence of NSCLC (P = 0.022). Peripheral neutrophil
J. Zhang S.-H. Huang H. Li Y. Li X.-L. Chen W.-Q. Zhang H.-G. Chen L.-J. Gu (&) Thoracic Surgery Department and Clinical Research Center for Thoracic Oncology, The Third Affiliated Hospital of Sun Yat-sen University, No. 600, Tianhe Road, Tianhe District, Guangzhou 510630, China e-mail: [email protected]
count had no impact on DFS or OS when analysis included all the 142 patients. Preoperative peripheral lymphocyte count, which is related with lymphatic invasion, is an independent favorable prognostic factor of DFS in patients with NSCLC who underwent lobectomy and lymph node dissection and adjuvant chemotherapy. Keywords Non-small-cell lung cancer Prognostic factor Lymphatic count Neutrophil count Lymphatic invasion Adjuvant chemotherapy Disease-free survival
Introduction Non-small-cell lung cancer (NSCLC) is the leading cause of cancer-related death for both men and women, and the overall 5-year survival rate is only 15 % [1]. Despite undergoing curative surgery, about 40 % of patients will present with local recurrence or metastasis in 2 years after surgery [2]. Investigators try to find new valuable prognostic factors to identify subsets of patients with poor disease-
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