Prognostic assessment of baseline neutrophil-to-lymphocyte ratio in locally advanced and metastatic lung cancer: A retrospective analysis from a tertiary care center in Northeast India

Background: The treatment for lung cancer has achieved notable advancements; however, there remains a critical need for the development of more refined strategies aimed at optimizing patient selection and enhancing the precision of prognostic evaluations for individuals afflicted with lung cancer. Leukocyte count, particularly neutrophils and lymphocytes, along with the Neutrophil to Lymphocyte ratio (NLR), stand as discerning markers of systemic inflammation, actively contributing in the regulation of cell-mediated antitumor responses. The primary objective of this study was to evaluate the prognostic implications associated with baseline NLR in patients diagnosed with locally advanced and metastatic lung cancer.Materials and Methods: Participants in this retrospective observational study were registered between January and December 2017 at the Dr. Bhubaneswar Borooah Cancer Institute. The demographic information, including clinical profiles and treatment-related characteristics, was gathered for these patients, who were diagnosed with locally advanced and metastatic lung cancer based on histological confirmation. The NLR was determined based on the quantification of neutrophils and lymphocytes. The survivorship between the groups was examined after two categories of NLR values—those with < 3> 3—were established. The Kaplan-Meier method was employed to analyze survival curves, and the log-rank test was performed to compare survival between different groups. In order to establish statistical significance, it was necessary for the p-value to be below 0.05.Results: The cohort was predominantly elderly males, with a median age of 60 years. Non-small cell lung carcinoma (NSCLC) accounted for 94% of cases, predominantly adenocarcinoma (60%). Over 90% of individuals were diagnosed with stage IV disease. Most patients (53%) received chemotherapy, with a median survival of 11 months for those with NLR < 3 p=0.180).> 3).Conclusions: Although high NLR was seen more in smokers and non-small cell histology, the results of our study do not support the prognostic role of pre-treatment NLR for overall survival in locally advanced and metastatic disease.