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The lymphocyte/monocyte ratio predicts poor clinical outcome and improves the predictive accuracy in patients with soft tissue sarcomas

Overview of attention for article published in International Journal of Cancer, January 2014
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Title
The lymphocyte/monocyte ratio predicts poor clinical outcome and improves the predictive accuracy in patients with soft tissue sarcomas
Published in
International Journal of Cancer, January 2014
DOI 10.1002/ijc.28677
Pubmed ID
Authors

Joanna Szkandera, Armin Gerger, Bernadette Liegl‐Atzwanger, Gudrun Absenger, Michael Stotz, Joerg Friesenbichler, Slave Trajanoski, Tatjana Stojakovic, Katharina Eberhard, Andreas Leithner, Martin Pichler

Abstract

Increasing evidence indicates the involvement of inflammation and coagulation in cancer progression and metastases. Inflammatory biomarkers hold great promise for improving the predictive ability of existing prognostic tools in cancer patients. In the present study, we investigated several inflammatory indices with regard to their prognostic relevance for predicting clinical outcome in soft tissue sarcoma (STS) patients. Three hundred and forty STS patients were divided into a training set (n = 170) and a validation set (n = 170). Besides well-established clinico-pathological prognostic factors, we evaluated the prognostic value of the neutrophil/lymphocyte (N/L) ratio, the lymphocyte/monocyte (L/M) ratio and the platelet/lymphocyte (P/L) ratio using Kaplan-Meier curves and univariate as well as multivariate Cox regression models. Additionally, we developed a nomogram by supplementing the L/M ratio to the well-established Kattan nomogram and evaluated the predictive accuracy of this novel nomogram by applying calibration and Harrell's concordance index (c-index). In multivariate analysis, a low L/M ratio was significantly associated with decreased CSS and DFS (HR = 0.41, 95% CI = 0.18-0.97, p = 0.043; HR = 0.39, 95% CI = 0.16-0.91, p = 0.031, respectively) in the training set. Using the validation set for confirmation, we found also in multivariate analysis an independent value for CSS (HR = 0.33, 95% CI = 0.12-0.90, p = 0.03) and for DFS (HR = 0.36, 95% CI = 0.16-0.79, p = 0.01). The estimated c-index was 0.74 using the original Kattan nomogram and 0.78 when the L/M ratio was added. Our study reports for the first time that the pre-operative L/M ratio represents a novel independent prognostic factor for prediction the clinical outcome in STS patients. This easily determinable biomarker might be helpful in improved individual risk assessment.

Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 57 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Austria 1 2%
Unknown 56 98%

Demographic breakdown

Readers by professional status Count As %
Researcher 14 25%
Student > Master 7 12%
Student > Ph. D. Student 7 12%
Student > Doctoral Student 6 11%
Lecturer 4 7%
Other 9 16%
Unknown 10 18%
Readers by discipline Count As %
Medicine and Dentistry 30 53%
Agricultural and Biological Sciences 6 11%
Pharmacology, Toxicology and Pharmaceutical Science 1 2%
Biochemistry, Genetics and Molecular Biology 1 2%
Nursing and Health Professions 1 2%
Other 2 4%
Unknown 16 28%