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The neutrophil-to-lymphocyte ratio as a novel independent prognostic factor for multiple metastatic lung tumors from various sarcomas

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Abstract

Purpose

Sarcomas are among the most refractory malignant tumors and often recur as pulmonary metastasis. Although the presence of a high neutrophil-to-lymphocyte ratio (NLR) has been associated with the prognosis of several malignancies, the relationship between the NLR and sarcoma with pulmonary metastasis is unclear. We investigated the impact of the NLR in patients who underwent surgical resection for metastatic lung tumors from various sarcomas.

Methods

The subjects of this retrospective study were 158 patients with metastatic lung tumors from various sarcomas, who underwent initial pulmonary metastasectomy between 2006 and 2015. We examined the clinicopathological variables, including the NLR and the characteristics of surgical procedures. Survival was estimated by the Kaplan–Meier method and prognostic factors were evaluated by multivariate analysis.

Results

Multivariate analysis revealed significantly better survival of the group with an NLR < 2.26 immediately before the most recent pulmonary metastasectomy, in addition to such factors as the largest resected lesion being < 22 mm, a disease-free interval of > 2 years, and 3 or more pulmonary metastasectomies.

Conclusion

The NLR immediately before the most recent pulmonary metastasectomy is a novel independent prognostic factor, which may be helpful when considering repeated pulmonary metastasectomy.

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Abbreviations

DFI:

Disease-free interval

OS:

Overall survival

NLR:

Neutrophil-to-lymphocyte ratio

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Acknowledgements

We thank Ms. Fumiko Isobe of the Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan, for her technical assistance.

Funding

This work was supported by a Management Expenses Grant for National University Corporations in Japan.

Author information

Authors and Affiliations

  1. Department of Thoracic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan

    Hiromasa Yamamoto, Kei Namba, Haruchika Yamamoto, Junichi Soh, Kazuhiko Shien, Ken Suzawa, Takeshi Kurosaki, Shinji Otani, Mikio Okazaki, Seiichiro Sugimoto, Masaomi Yamane, Takahiro Oto & Shinichi Toyooka

  2. Department of Diagnostic Pathology, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan

    Tomohiro Toji

  3. Department of Orthopedic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan

    Toshiyuki Kunisada

  4. Center for Multidisciplinary Treatment of Sarcoma, Department of Sarcoma Medicine, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, 296-8602, Japan

    Katsuhito Takahashi

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  1. Hiromasa Yamamoto
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Correspondence to Hiromasa Yamamoto.

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595_2020_2093_MOESM4_ESM.pdf

Supplementary file4 Supplementary Fig. 1. Distribution of the neutrophil-to-lymphocyte ratio (NLR) immediately before (A) the first and (B) the most recent pulmonary metastasectomy. The difference in the distribution of NLR between the group with vs. the group without preoperative chemotherapy was analyzed. The Man-Whitney U test was performed. (PDF 163 kb)

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Yamamoto, H., Namba, K., Yamamoto, H. et al. The neutrophil-to-lymphocyte ratio as a novel independent prognostic factor for multiple metastatic lung tumors from various sarcomas. Surg Today 51, 127–135 (2021). https://doi.org/10.1007/s00595-020-02093-5

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  • DOI: https://doi.org/10.1007/s00595-020-02093-5

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