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Article: Pre-radiotherapy lymphocyte count and platelet-to-lymphocyte ratio may improve survival prediction beyond clinical factors in limited stage small cell lung cancer: model development and validation

TitlePre-radiotherapy lymphocyte count and platelet-to-lymphocyte ratio may improve survival prediction beyond clinical factors in limited stage small cell lung cancer: model development and validation
Authors
KeywordsLimited-stage small-cell lung cancer (SCLC)
overall survival (OS)
predictive model
lymphocyte count
platelet-to-lymphocyte ratio
Issue Date2020
PublisherAME Publishing Company. The Journal's web site is located at http://www.tlcr.org/
Citation
Translational Lung Cancer Research, 2020, v. 9 n. 6, p. 2315-2327 How to Cite?
AbstractBackground: Few small sample size studies have reported lymphocyte count was prognostic for survival in small-cell lung cancer (SCLC). This study aimed to validate this finding, to build prediction model for overall survival (OS) and to study whether novel models that combine lymphocyte-related variables can predict OS more accurately than a conventional model using clinical factors alone in a large cohort of limited-stage SCLC patients. Methods: This study enrolled 544 limited-stage SCLC patients receiving definitive chemo-radiation with pre-radiotherapy lymphocyte-related variables including absolute lymphocyte count (ALC), platelet-to-lymphocyte ratio (P/L ratio), neutrophil-to-lymphocyte ratio (N/L ratio), and lymphocyte-to-monocyte ratio (L/M ratio). The primary endpoint was OS. These patients were randomly divided into a training dataset (n=274) and a validation dataset (n=270). Multivariate survival models were built in the training dataset, and the performance of these models were further tested in the validation dataset using the concordance index (C-index). Results: The median follow-up time was 36 months for all patients. In the training dataset, univariate analysis showed that ALC (P=0.020) and P/L ratio (P=0.023) were significantly correlated with OS, while L/M ratio (P=0.091) and N/L ratio (P=0.436) were not. Multivariate modeling demonstrated the significance of ALC (P=0.063) and P/L ratio (P=0.003), and the improvement for OS prediction in combined models with the addition of ALC (C-index =0.693) or P/L ratio (C-index =0.688) over the conventional model (C-index =0.679). The validation dataset analysis confirmed a modest improvement of C-index with the addition of ALC or P/L ratio. All these models showed reasonable discriminations and calibrations. Conclusions: This study validated the significant value of pre-radiotherapy ALC and P/L ratio on OS in limited-stage SCLC. The combined model with ALC or P/L ratio showed additional OS prediction values than the conventional model with clinical factors alone.
Persistent Identifierhttp://hdl.handle.net/10722/302052
ISSN
2023 Impact Factor: 4.0
2023 SCImago Journal Rankings: 1.318
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorYu, Y-
dc.contributor.authorWang, L-
dc.contributor.authorCao, S-
dc.contributor.authorGao, S-
dc.contributor.authorWang, W-
dc.contributor.authorMulvihill, L-
dc.contributor.authorMachtay, M-
dc.contributor.authorFu, P-
dc.contributor.authorYu, J-
dc.contributor.authorKong, FMS-
dc.date.accessioned2021-08-21T03:30:53Z-
dc.date.available2021-08-21T03:30:53Z-
dc.date.issued2020-
dc.identifier.citationTranslational Lung Cancer Research, 2020, v. 9 n. 6, p. 2315-2327-
dc.identifier.issn2218-6751-
dc.identifier.urihttp://hdl.handle.net/10722/302052-
dc.description.abstractBackground: Few small sample size studies have reported lymphocyte count was prognostic for survival in small-cell lung cancer (SCLC). This study aimed to validate this finding, to build prediction model for overall survival (OS) and to study whether novel models that combine lymphocyte-related variables can predict OS more accurately than a conventional model using clinical factors alone in a large cohort of limited-stage SCLC patients. Methods: This study enrolled 544 limited-stage SCLC patients receiving definitive chemo-radiation with pre-radiotherapy lymphocyte-related variables including absolute lymphocyte count (ALC), platelet-to-lymphocyte ratio (P/L ratio), neutrophil-to-lymphocyte ratio (N/L ratio), and lymphocyte-to-monocyte ratio (L/M ratio). The primary endpoint was OS. These patients were randomly divided into a training dataset (n=274) and a validation dataset (n=270). Multivariate survival models were built in the training dataset, and the performance of these models were further tested in the validation dataset using the concordance index (C-index). Results: The median follow-up time was 36 months for all patients. In the training dataset, univariate analysis showed that ALC (P=0.020) and P/L ratio (P=0.023) were significantly correlated with OS, while L/M ratio (P=0.091) and N/L ratio (P=0.436) were not. Multivariate modeling demonstrated the significance of ALC (P=0.063) and P/L ratio (P=0.003), and the improvement for OS prediction in combined models with the addition of ALC (C-index =0.693) or P/L ratio (C-index =0.688) over the conventional model (C-index =0.679). The validation dataset analysis confirmed a modest improvement of C-index with the addition of ALC or P/L ratio. All these models showed reasonable discriminations and calibrations. Conclusions: This study validated the significant value of pre-radiotherapy ALC and P/L ratio on OS in limited-stage SCLC. The combined model with ALC or P/L ratio showed additional OS prediction values than the conventional model with clinical factors alone.-
dc.languageeng-
dc.publisherAME Publishing Company. The Journal's web site is located at http://www.tlcr.org/-
dc.relation.ispartofTranslational Lung Cancer Research-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectLimited-stage small-cell lung cancer (SCLC)-
dc.subjectoverall survival (OS)-
dc.subjectpredictive model-
dc.subjectlymphocyte count-
dc.subjectplatelet-to-lymphocyte ratio-
dc.titlePre-radiotherapy lymphocyte count and platelet-to-lymphocyte ratio may improve survival prediction beyond clinical factors in limited stage small cell lung cancer: model development and validation-
dc.typeArticle-
dc.identifier.emailKong, FMS: kong0001@hku.hk-
dc.identifier.authorityKong, FMS=rp02508-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.21037/tlcr-20-666-
dc.identifier.pmid33489795-
dc.identifier.pmcidPMC7815357-
dc.identifier.scopuseid_2-s2.0-85100168673-
dc.identifier.hkuros324255-
dc.identifier.volume9-
dc.identifier.issue6-
dc.identifier.spage2315-
dc.identifier.epage2327-
dc.identifier.isiWOS:000607369400005-
dc.publisher.placeHong Kong-

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