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Research ArticleClinical Studies

Elevation of the Neutrophil-to-Lymphocyte Ratio Is a Significant Postoperative Poor Prognostic Factor in Patients With Clinical T3-4 Centrally Located Primary Lung Cancer

TAKUMA TSUKIOKA, NOBUHIRO IZUMI, HIROAKI KOMATSU, HIDETOSHI INOUE, RYUICHI ITO, SATOSHI SUZUKI and NORITOSHI NISHIYAMA
Anticancer Research April 2023, 43 (4) 1631-1636; DOI: https://doi.org/10.21873/anticanres.16313
TAKUMA TSUKIOKA
Department of Thoracic Surgery, Osaka Metropolitan University, Osaka, Japan
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  • For correspondence: t-tsukioka@omu.ac.jp
NOBUHIRO IZUMI
Department of Thoracic Surgery, Osaka Metropolitan University, Osaka, Japan
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HIROAKI KOMATSU
Department of Thoracic Surgery, Osaka Metropolitan University, Osaka, Japan
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HIDETOSHI INOUE
Department of Thoracic Surgery, Osaka Metropolitan University, Osaka, Japan
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RYUICHI ITO
Department of Thoracic Surgery, Osaka Metropolitan University, Osaka, Japan
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SATOSHI SUZUKI
Department of Thoracic Surgery, Osaka Metropolitan University, Osaka, Japan
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NORITOSHI NISHIYAMA
Department of Thoracic Surgery, Osaka Metropolitan University, Osaka, Japan
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Abstract

Background/Aim: In centrally located non-small cell lung cancer (CLNSCLC) surgery, large tumors and extension to neighboring structures prevent the attainment of adequate surgical fields and make operations more difficult, and some patients have extremely poor outcomes. This study aimed to identify novel postoperative prognostic factors in patients with advanced CLNSCLC. Patients and Methods: CLNSCLC was defined as a tumor requiring pneumonectomy or sleeve lobectomy for complete removal. We retrospectively investigated the clinical courses of 35 patients with cT3-4 CLNSCLC. Results: This study included 21 patients with cT3 and 14 with cT4 lung cancer. Nine patients underwent pneumonectomy and 26 underwent sleeve lobectomy. Univariate analysis revealed that a high neutrophil-to-lymphocyte ratio (NLR, p=0.005) and carcinoembryonic antigen (CEA) positivity (p=0.028) were significant poor prognostic factors. Only high NLR (p=0.020) was a significant independent predictor in multivariate analysis. Nine of 16 patients with high NLR (56%) experienced disease recurrence, whereas 6 of 19 patients without high NLR (32%) had recurrent disease. Conclusion: High NLR and CEA positivity were significant poor prognostic factors in patients with cT3-4 CLNSCLC, and only high NLR was an independent predictor. Our findings may be helpful in selecting optimal treatments for advanced CLNSCLC.

Key Words:
  • Advanced centrally located lung cancer
  • prognostic factor
  • neutrophil-to-lymphocyte ratio
  • Received November 6, 2022.
  • Revision received November 21, 2022.
  • Accepted November 22, 2022.
  • Copyright © 2023 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.
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Anticancer Research: 43 (4)
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Elevation of the Neutrophil-to-Lymphocyte Ratio Is a Significant Postoperative Poor Prognostic Factor in Patients With Clinical T3-4 Centrally Located Primary Lung Cancer
TAKUMA TSUKIOKA, NOBUHIRO IZUMI, HIROAKI KOMATSU, HIDETOSHI INOUE, RYUICHI ITO, SATOSHI SUZUKI, NORITOSHI NISHIYAMA
Anticancer Research Apr 2023, 43 (4) 1631-1636; DOI: 10.21873/anticanres.16313

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Elevation of the Neutrophil-to-Lymphocyte Ratio Is a Significant Postoperative Poor Prognostic Factor in Patients With Clinical T3-4 Centrally Located Primary Lung Cancer
TAKUMA TSUKIOKA, NOBUHIRO IZUMI, HIROAKI KOMATSU, HIDETOSHI INOUE, RYUICHI ITO, SATOSHI SUZUKI, NORITOSHI NISHIYAMA
Anticancer Research Apr 2023, 43 (4) 1631-1636; DOI: 10.21873/anticanres.16313
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Keywords

  • Advanced centrally located lung cancer
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