Prognostic value of preoperative mGPS, CAR, and NLR in patients undergoing resection for non-small cell lung cancer

Systemic inflammation is increasingly recognized as a crucial prognostic factor in non-small cell lung cancer (NSCLC). However, comprehensive evaluations comparing multiple inflammation-based indices in surgically treated cohorts, especially across specific time-dependent survival endpoints, remain scarce. This retrospective observational cohort study analyzed 270 NSCLC patients who underwent surgical resection of the primary tumor within the Konya City Hospital healthcare network. Preoperative inflammatory indices calculated included C-reactive protein to albumin ratio (CAR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), platelet-to-albumin ratio (PAR), and modified Glasgow Prognostic Score (mGPS). We assessed overall survival and time-specific survival at 1, 2, and 5 years. Group comparisons were conducted based on survival status at each time point, utilizing univariate and multivariable logistic regression to identify factors associated with time-specific survival. The mean age of the cohort was 71.64 ± 9.71 years, with 78.9% being male. Lobectomy was the most frequent procedure (72.6%). During follow-up, 145 patients died (overall mortality rate of 53.7%). Among these, the mean time from surgery to death was 32.63 ± 23.83 months. Survival rates at 1, 2, and 5 years were 90.0%, 79.3%, and 53.3%, respectively. Inflammatory indices were consistently elevated in non-survivors across all evaluated time points. In multivariable models, CAR and high mGPS status were independently associated with reduced 1-year survival. At 2 years, CAR and high mGPS status maintained their independent association with diminished survival, while NLR demonstrated borderline significance. For 5-year survival, high mGPS status and NLR remained independently associated with reduced survival. Unadjusted analyses revealed a graded association between mGPS and survival. Our findings indicate that preoperative systemic inflammation, particularly elevated mGPS status, CAR, and NLR, is associated with mortality at multiple postoperative time points following NSCLC resection. These results underscore the potential prognostic utility of readily available inflammation-based biomarkers and necessitate further validation through prospective investigations.