Association between neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and survival in undifferentiated pleomorphic sarcoma (NLR, PLR, and overall survival in UPS)

• Published in: Surgical oncology 2023-08, Vol.49, p.101949-101949, Article 101949
• Main Authors: Tepper, Sarah C., Lee, Linus, Fice, Michael P., Jones, Conor M., Klein, Evan D., Vijayakumar, Gayathri, Batus, Marta, Colman, Matthew W., Gitelis, Steven, Blank, Alan T.
• Format: Article
• Language: English
• Subjects: Biomarker; Inflammation; Lymphocyte; Neutrophil; Platelet; Sarcoma
• ISSN: 0960-7404; 1879-3320
• DOI: 10.1016/j.suronc.2023.101949

Cancer-related inflammation has been shown to be a driver of tumor growth and progression, and there has been a recent focus on identifying markers of the inflammatory tumor microenvironment. Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are inflammatory indices that have been identified as prognostic biomarkers in various malignancies. However, there is limited and conflicting data regarding their prognostic value in soft tissue sarcoma (STS) and specifically in undifferentiated pleomorphic sarcoma (UPS). This was a retrospective review of patients who underwent surgical treatment for primary UPS from 1993 to 2021. Cutoff values for NLR and PLR were determined by receiver operating curve analysis. Cox proportional hazards regression was used to determine prognostic factors on univariate and multivariate analysis. Eighty-six patients were included. The optimal cutoff value was 3.3 for NLR and 190 for PLR. Both high NLR (HR 2.44; 95% CI 1.29–4.63; p = 0.005) and high PLR (HR 1.99; 95% CI 1.08–3.67, p = 0.02) were associated with worse OS on univariate analysis. On multivariate analysis, metastasis at presentation and radiotherapy were independently predictive of OS, but high NLR (HR 1.30; 95% CI 0.64–2.98; p = 0.41) and high PLR (HR 1.63; 95% CI 0.82–3.25; p = 0.17) were not predictive of survival. High pre-treatment NLR and PLR were associated with decreased overall survival but were not independent predictors of survival in patients undergoing resection for UPS. Until additional prospective studies can be done, survival outcomes are best predicted using previously established patient- and tumor-specific factors. •Cancer-related inflammation has been shown to be a driver of tumor growth and progression.•NLR and PLR are inflammatory biomarkers that have been shown to have prognostic significance in various malignancies.•High NLR and PLR were not independent predictors of survival in patients with undifferentiated pleomorphic sarcoma.•High NLR and PLR were associated with known poor prognostic factors, including larger tumor size and higher grade.•NLR and PLR may allow for identification of patients with poorer prognoses who may benefit from multimodal treatment.