Neutrophil-to-lymphocyte ratio in primary mediastinal germ cell tumors: A retrospective analysis of >20 years single institution experience

• Published in: Current problems in cancer Vol. 44; no. 4; p. 100537
• Main Authors: Géczi, Lajos, Budai, Barna, Polk, Nándor, Fazekas, Fruzsina, Bodrogi, István, Biró, Krisztina
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2020
• Subjects: BEP chemotherapy; Neutrophil-to-lymphocyte ratio; Primary mediastinal germ cell tumor; Prognostic model; Survival; Primary mediastinal germ cell tumor; Prognostic model; BEP chemotherapy; Neutrophil-to-lymphocyte ratio; Survival
• ISSN: 0147-0272; 1535-6345
• DOI: 10.1016/j.currproblcancer.2020.100537

Objectives: To obtain information on outcome stratified by histology, extent and primary treatment patients’ data with primary malignant mediastinal germ cell tumors treated between 1998 and 2018 were retrospectively analyzed. Methods: The primary treatment for localized malignant mediastinal germ cell tumors was neoadjuvant bleomycin + etoposid + cisplatin (BEP) ± surgery (n = 22); or surgery ± adjuvant BEP (n = 16). For disseminated disease (n = 21) first line BEP ± second line chemotherapy were administered. For nonseminomas (NS) the NLR at start of BEP was analyzed in relation to disease-free survival (DFS), progression-free survival (PFS), and overall survival (OS). Results: After neoadjuvant treatment the 5-year DFS was 100% for seminomas (S), and 63.4% for NS. The 5-year OS was 100% for S, and 76.9% for NS. The 5-year DFS and OS after surgery ± BEP for S was 72.9% and 100%, for NS was 75% and 87.5%, respectively. The 5-year PFS and OS of metastatic patients for S was 60% and 80%, while the median PFS and OS of NS were 5.7 and 11.1 months, respectively. Objective response (P = 0.006) and low NLR (P = 0.043) were independent prognostic markers of longer OS. Conclusions: We confirmed the good outcome of BEP-treated S, while NS had poorer prognosis. Previously published prognostic models for NS were validated. Based on NLR and response a new prognostic model was developed.