Elevated blood neutrophil-to-lymphocyte ratio: A readily available biomarker associated with death due to disease in high risk nonmetastatic melanoma Journal Article


Authors: Davis, J. L.; Langan, R. C.; Panageas, K. S.; Zheng, J.; Postow, M. A.; Brady, M. S.; Ariyan, C.; Coit, D. G.
Article Title: Elevated blood neutrophil-to-lymphocyte ratio: A readily available biomarker associated with death due to disease in high risk nonmetastatic melanoma
Abstract: Background: Elevated peripheral blood neutrophil-to-lymphocyte ratio (NLR) is associated with poor oncologic outcomes in patients with stage IV melanoma and other solid tumors, but its impact has not been characterized for patients with high-risk, nonmetastatic melanoma. Methods: Retrospective review of a melanoma database identified patients with high-risk melanoma who underwent operation with curative intent at a single institution. NLR was calculated from blood samples obtained within 2 weeks before operation. Multiple primary melanomas and concurrent hematologic or other metastatic malignancies were excluded. Cumulative incidence of death due to disease was estimated, and Gray’s test was used to examine the effect of NLR on melanoma disease-specific death (DOD). Multivariable competing risks regression models assessed associated factors. Results: Data on 1431 patients with high-risk, nonmetastatic melanoma were analyzed. Median follow-up for survivors was 4 years. High NLR (≥3 or as continuous variable) was associated with older age, male sex, thicker primaries, higher mitotic index, and more advanced nodal status. On multivariate analysis, high NLR (≥3 or as a continuous variable), older age, male sex, ulcerated primary, lymphovascular invasion, and positive nodal status were all independently associated with worse DOD. Conclusions: NLR is a readily available blood test that was independently associated with DOD in patients with high-risk, nonmetastatic melanoma. It is unclear whether high NLR is a passive indicator of poor prognosis or a potential therapeutic target. Further studies to evaluate the prognostic role of NLR to potentially identify those more likely to benefit from adjuvant immunotherapy may prove informative. © 2017, Society of Surgical Oncology.
Keywords: adolescent; adult; child; aged; major clinical study; cancer risk; cancer patient; follow up; biological marker; melanoma; medical record review; retrospective study; cancer mortality; high risk patient; cancer survivor; risk assessment; lymph vessel metastasis; human; male; female; article; neutrophil lymphocyte ratio; nonmetastatic melanoma
Journal Title: Annals of Surgical Oncology
Volume: 24
Issue: 7
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2017-07-01
Start Page: 1989
End Page: 1996
Language: English
DOI: 10.1245/s10434-017-5836-0
PROVIDER: scopus
PUBMED: 28303429
PMCID: PMC5751419
DOI/URL:
Notes: Article -- Export Date: 3 July 2017 -- Source: Scopus
Altmetric Score
MSK Authors
  1. Junting Zheng
    131 Zheng
  2. Michael Andrew Postow
    187 Postow
  3. Katherine S Panageas
    329 Panageas
  4. Mary Sue Brady
    165 Brady
  5. Charlotte Eielson Ariyan
    78 Ariyan
  6. Daniel Coit
    421 Coit
  7. Jeremy Lee Davis
    5 Davis
  8. Russell Charles Langan
    5 Langan