P11.31.B NEUTROPHIL-TO-LYMPHOCYTE RATIO AS AN INDEPENDENT PROGNOSTIC MARKER FOR BRAIN METASTASIS: A RETROSPECTIVE COHORT STUDY

Abstract BACKGROUND Brain metastases (BM) remain the most common intracranial tumors with dismal prognosis despite advances in therapy. Identifying accessible prognostic markers is crucial for optimizing patient management. The neutrophil-to-lymphocyte ratio (NLR), a simple systemic inflammation marker, has shown promise in predicting cancer outcomes. This study aimed to evaluate the prognostic value of NLR in patients with brain metastases. MATERIAL AND METHODS A retrospective analysis was conducted on 338 patients with histopathologically confirmed brain metastases from January 2019 to December 2023. Clinical parameters, including gender, age, onset of symptoms, and Karnofsky Performance Status (KPS), were collected. NLR was calculated from routine blood samples with cut-off points of 4 for subgroup analysis. Kaplan-Meier survival analysis, bivariate correlation, and multivariate Cox regression were performed to identify independent prognostic factors for overall survival (OS). RESULTS Male gender (61.2%) and age <60 years (65.1%) predominated. A higher NLR (>4) was associated with worse survival outcomes. Multivariate analysis identified acute onset (HR 0.670, p=0.015) and NLR >4 (HR 3.465, p=0.008) as independent predictors of mortality. Kaplan-Meier analysis demonstrated significantly better survival in patients with NLR <4 (p=0.004). Patients with NLR <4 also had a notably higher 2-year survival rate (66% vs 32%). CONCLUSION Elevated NLR is significantly associated with poorer survival in brain metastasis patients, with a cut-off value of 4 providing the strongest prognostic stratification. Routine NLR assessment offers a practical and cost-effective tool for prognosis estimation and treatment planning in neuro-oncology practice.