Changes in the neutrophil to lymphocyte ratio as predictors of outcome in pediatric patients with central nervous system tumors undergoing surgical resection

Article type: Research Article

Authors: Flores-Bustamante, Al^a | Hernández-Regino, Laura^a | Castillejos-López, Manuel-De-Jesús^{b; *} | Martínez-Rodríguez, Daniel^a | Aquino-Gálvez, Arnoldo^c | Zapata-Tarrés, Marta^d | de Uña-Flores, Armando^e | Salinas-Lara, Citlaltepetl^f | Sierra-Vargas, Patricia^g | Torres-Espíndola, Luz María^{a; *}

Affiliations: [a] Pharmacology Laboratory, National Institute of Pediatrics, Mexico City, Mexico | [b] Hospital Epidemiology and Infectology Unit, National Institute of Respiratory Diseases, Mexico City, Mexico | [c] Biomedical Oncology Laboratory, National Institute of Respiratory Diseases, Mexico City, Mexico | [d] Oncology Service, National Institute of Paediatrics, Mexico City, Mexico | [e] Radiology and Imaging Service, National Institute of Paediatrics, Mexico City, Mexico | [f] Pathology Department, National Institute of Neurology and Neurosurgery, Mexico City, Mexico | [g] Biochemist Research and Environmental Medicine Laboratory, National Institute of Respiratory Diseases “Ismael Cosio Villegas”, Mexico City, Mexico

Correspondence: [*] Corresponding authors: Luz María Torres Espíndola, Laboratory of Pharmacology, National Institute of Pediatrics, Mexico City, México. Tel.: +52 10840900 ext. 1426, 1428; E-mail: ltorrese@pediatria. gob.mx, [email protected]. Manuel de Jesús Castillejos López, Hospital epidemiology unit and infectology, National Institute of Respiratory Diseases “Ismael Cosio Villegas”, Mexico City, México. Tel.: +52 54871700 ext. 5238; E-mail: [email protected].

Abstract: BACKGROUND: Changes in neutrophil to lymphocyte ratio (ΔNLR) have been used as a clinical tool for stratification and prognosis of patients with solid tumors, there is scarce evidence of their clinical relevance in patients with tumors of the central nervous system who have also undergone surgical resection. OBJECTIVE: Determine if (ΔNLR) are associated with poor response to treatment and worse prognosis in pediatric patients with central nervous system tumors (CNST) who underwent surgical resection. METHODS: We performed a retrospective cohort study; demographic, clinical, and hematological variables were evaluated, Kaplan-Meier survival curves and Cox proportional hazards regression model were performed to evaluate prognosis. RESULTS: The ΔNLR cutoff value obtained through the third interquartile range was 4.30; The probability of survival and complete response to treatment was different between patients with high ΔNLR when compared to patients with low ΔNLR (p= 0.013, p=≪ 0.001, respectively). A high ΔNLR behaved as an independent predictor of worse Overall Survival (HR 2,297; 95% CI: 1,075–4.908, p= 0.032). CONCLUSION: An elevated ΔNLR was a predictor of poor response to treatment and a prognostic factor for worse Overall Survival in pediatric patients with CNST undergoing surgical resection.

Keywords: Central nervous system tumors, pediatric, neutrophil-to-lymphocyte ratio, prognostic factor, survival, tumor resection

DOI: 10.3233/CBM-200857

Journal: Cancer Biomarkers, vol. 33, no. 3, pp. 291-298, 2022