Relationship Between Prognosis and Neutrophil: Lymphocyte and Platelet:Lymphocyte Ratios in Patients with Malignant Pleural Mesotheliomas


Background: It has been demonstrated that neutrophil:lymphocyte (NLR) and platelet:lymphocyte (PLR)ratios are associated with prognosis in cancer patients. The aim of this study was to investigate whetherpretreatment white blood cell (WBC), neutrophil, lymphocyte, monocyte, platelet, basophil and eosinophil counts,LDH level, NLR and PLR are associated with prognosis in patients with malignant pleural mesothelioma (MPM).Materials and
Methods: We retrospectively reviewed files of 50 patients who were managed with a diagnosis ofMPM between 2005 and 2010. Demographic and clinical characteristics, treatments, response to treatment andprognostic factors were evaluated, along with relationships between pretreatment blood parameters and prognosis.
Results: Overall, 38 men and 12 women were included to the study. Mean age was 61.5±9.4 years (range: 39-83years). There was advanced disease in 86% (n=43) and the histological type was epithelial mesothelioma in themajority (82%). Of the cases, 17 (34%) received radiotherapy, while 42 cases underwent first- and second-linechemotherapy, with cisplatin plus pemetrexed as the most commonly used regimen. In the assessment aftertherapy, it was found that there was complete response in 4 cases (8%), partial response in 10 cases (20%),stable disease in 17 cases (34%) and progression in 19 cases (38%). Median follow-up was 10 months (range: 10day-30 months). Median overall survival was found to be 20.7 months while median progression-free survivalas 10 months. In univariate and multivariate analyses, it was found that factors significantly affecting overallsurvival included stage (p=0.030), response to treatment (p=0.026) and monocyte count (p=0.004), while factorsaffecting disease-free survival included NLR (p=0.018), response to treatment (p=0.001), and PLR score (p=0.003).
Conclusions: Overall and disease-free survival was found to be better in cases with a WBC count<8.000, plateletcount<300,000, and low NLR and PLR scores in malignant pleural mesothelioma.