The combination of baseline neutrophil to lymphocyte ratio and dynamic changes during treatment can better predict the survival of osteosarcoma patients

Longqing Li; Ye Li; Minxun Lu; Yitian Wang; Zhuangzhuang Li; Xin Hu; Xuanhong He; Taojun Gong; Yi Luo; Yong Zhou; Li Min; Chongqi Tu

doi:10.3389/fonc.2023.1235158

The combination of baseline neutrophil to lymphocyte ratio and dynamic changes during treatment can better predict the survival of osteosarcoma patients

Front Oncol. 2023 Nov 14:13:1235158. doi: 10.3389/fonc.2023.1235158. eCollection 2023.

Authors

Longqing Li^#¹, Ye Li^#¹, Minxun Lu¹, Yitian Wang¹, Zhuangzhuang Li¹, Xin Hu¹, Xuanhong He¹, Taojun Gong¹, Yi Luo¹, Yong Zhou¹, Li Min¹, Chongqi Tu¹

Affiliation

¹ Department of Orthopedics, Orthopedics Research Institute, West China Hospital, Sichuan University, Chengdu, China.

^# Contributed equally.

Abstract

Background: Osteosarcoma is a primary malignant bone tumor with a high metastatic potential that accounts for a significant proportion of all bone tumors. The prognosis for patients with metastatic or recurrence disease remains poor. The neutrophil-to-lymphocyte ratio (NLR) has become a potential prognostic biomarker for cancer. Recent evidence suggests that the dynamic changes in neutrophil-to-lymphocyte ratio (NLR) during treatment may be more informative in predicting patient prognosis, but the value of dynamic NLR in osteosarcoma has not yet been determined.

Methods: This retrospective study retrospectively analyzed the clinical information of 251 osteosarcoma patients diagnosed and treated in West China Hospital of Sichuan University, explored the impact of baseline NLR and changes in NLR during treatment on the prognosis of osteosarcoma patients, and further combined baseline NLR with Delta NLR to build an NLR staging system.

Results: The results showed that both baseline NLR and delta NLR had some predictive ability for the prognosis of osteosarcoma patients (P = 6.90e-4, P = 0.022). Patients with high baseline NLR were more likely to have a decrease in delta NLR (P = 1.24e-10). The NLR stage had a better predictive ability than baseline NLR and delta NLR, and was an independent prognostic factor for overall survival in osteosarcoma patients HR: 2.456 (1.625-3.710) (P = 1.97e-05).

Conclusion: NLR has value in continuous monitoring, and continuous monitoring of NLR can better predict the survival of osteosarcoma patients compared to baseline NLR.

Keywords: neutrophils-to-lymphocytes ratio; osteosarcoma; prognosis; risk model; survival.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by 1·3·5 project for disciplines of excellence, West China Hospital, Sichuan University (ZYJC18036) and the Science and Technology Research Program of Sichuan Province (2022YFG0109).