Prognostic Value of Neutrophil Lymphocyte Ratio in Second Line Advanced Malignant Pleural Mesothelioma

Abstract

Background: Malignant pleural mesothelioma is a lethal disease and hence the strong need for identifying new prognostic factors. Methods: This is a retrospective study including all eligible patients with advanced malignant pleural mesothelioma (MPM) presenting to National Cancer Institute, Cairo University. Neutrophil lymphocyte (N/L) ratio was assessed before second line chemotherapy. 2.5 was used as the cutoff point. Endpoints were the assessment of correlation between N/L ratio and clinical response (CR), progression free survival (PFS) and overall survival (OS). Results: 52 patients (19 stage III and 33 stage IV) MPM were included and followed up during the period from July 2009 till November 2012 with a median follow-up period of 2.6 months. 87.5% of patients with N/L ratio > 2.5 showed progressive disease versus 91.7% in patients with N/L ratio < 2.5 (P-value = 0.66). 6-month PFS was 11% for patients with N/L ratio > 2.5 versus 14% for patients with N/L ratio < 2.5 (P-value = 0.001). 6-month OS was 72% for patients with N/L ratio > 2.5 versus 66% for patients with N/L ratio < 2.5 (P-value = 0.4). Conclusion: N/L ratio is a potential prognostic marker for advanced MPM treated with second line chemotherapy.