The advanced lung cancer inflammation index is an independent prognostic factor after surgical resection in patients with non-small-cell lung cancer

• Published in: Interactive cardiovascular and thoracic surgery Vol. 26; no. 2; pp. 288 - 292
• Main Authors: Tomita, Masaki, Ayabe, Takanori, Nakamura, Kunihide
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.02.2018
• Subjects: Aged; Aged, 80 and over; Carcinoembryonic Antigen; Carcinoma, Non-Small-Cell Lung - mortality; Carcinoma, Non-Small-Cell Lung - pathology; Carcinoma, Non-Small-Cell Lung - surgery; Female; Humans; Lung Neoplasms - mortality; Lung Neoplasms - pathology; Lung Neoplasms - surgery; Lymphocyte Count; Male; Middle Aged; Neutrophils; Pneumonia - mortality; Pneumonia - pathology; Pneumonia - surgery; Prognosis; Proportional Hazards Models; Retrospective Studies; Serum Albumin; Survival Rate; Non-small-cell lung cancer; Prognosis; Advanced lung cancer inflammation index; Surgery
• ISSN: 1569-9293; 1569-9285; 1569-9285
• DOI: 10.1093/icvts/ivx329

Abstract OBJECTIVES The usefulness of a recently developed advanced lung cancer inflammation index (ALI) has been reported in advanced non-small-cell lung cancer (NSCLC) and small-cell lung cancer. However, no previous studies have examined the prognostic significance of ALI in patients with operable NSCLC. Therefore, the aim of this study was to explore the relationship between ALI and the prognosis of resected NSCLC. METHODS Three hundred and forty-three patients with NSCLC who underwent surgery at our institution between 2008 and 2012 were included. The ALI score was calculated as body mass index × serum albumin/neutrophil to lymphocyte ratio. A Web-based software programme [Cutoff Finder (http://molpath.charite.de/cutoff/)] was used to determine the optimal cut-off value for ALI. The Kaplan–Meier methods and a multivariable Cox proportional hazards model were used to evaluate the potential prognostic factors. RESULTS The optimal cut-off value of ALI was defined as 37.66. The low-ALI group (ALI < 37.66) displayed more adverse clinical characteristics. Furthermore, compared with patients in the high-ALI group (ALI > 37.66), those in the low-ALI group had significantly poorer survival rates. On multivariable analysis, gender, histological diagnosis, pN status, serum carcinoembryonic antigen level, serum C-reactive protein level and ALI were associated independently with cancer-specific survival. CONCLUSIONS This study is the first to investigate whether ALI is useful for predicting postoperative survival in patients with NSCLC. Preoperative ALI might serve as a potentially clinically valuable marker of the prognosis for patients with operable NSCLC.