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Neutrophil:Lymphocyte Ratio and Intraoperative Use of Ketorolac or Diclofenac are Prognostic Factors in Different Cohorts of Patients Undergoing Breast, Lung, and Kidney Cancer Surgery

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Forget, Patrice [UCL] Machiels, Jean-Pascal [UCL] Coulie, Pierre G. [UCL] Berlière, Martine [UCL] Poncelet, Alain [UCL] Tombal, Bertrand [UCL] Legrand, Catherine [UCL] De Kock, Marc [UCL]

BACKGROUND: Inflammation is associated with a worse outcome in cancer and neutrophil:lymphocyte ratio (NLR) is a strong prognostic value. In cancer, nonsteroidal anti-inflammatory drugs (NSAIDs) could be of interest. We investigated the prognostic significance of NLR and the impact of intraoperative NSAIDs in cancer surgeries. METHODS: We performed an observational study in early breast, kidney, and lung cancers (357, 227, and 255 patients) with uni- and multivariate analyses (Cox model). RESULTS: In breast cancer (Centre 1), NLR ≥ 4 is associated with a higher risk of relapse (hazards ratio (HR) = 2.41; 95 % confidence interval (CI) 1.01-5.76; P = 0.048). In breast cancer (Centre 2), NLR ≥ 3 is associated with a higher risk of relapse (HR = 4.6; 95 % CI 1.09-19.1; P = 0.04) and higher mortality (HR = 4.0; 95 % CI 1.12-14.3; P = 0.03). In kidney cancer, NLR ≥ 5 is associated with a higher risk of relapse (HR = 1.63; 95 % CI 1.00-2.66; P = 0.05) and higher mortality (HR = 1.67; 95 % CI 1.0-2.81; P = 0.05). In lung cancer, NLR ≥ 5 is associated with higher mortality (HR = 1.45; 95 % CI 1.02-2.06; P = 0.04). The intraoperative use of NSAIDs in breast cancer patients (Centre 1) is associated with a reduced recurrence rate (HR = 0.17; 95 % CI 0.04-0.43; P = 0.0002) and a lower mortality (HR = 0.25; 95 % CI 1.08-0.75; P = 0.01). NSAIDs use at the beginning of the surgery is independently associated with a lower metastases risk after lung cancer surgery (HR = 0.16; 95 % CI 0.04-0.63; P = 0.009). Ketorolac use is independently associated with longer survival (HR = 0.55; 95 % CI 0.31-0.95; P = 0.03). CONCLUSIONS: In these cohorts, these analyses show that NLR is a strong perioperative prognosis factor for breast, lung, and kidney cancers. In this context, intraoperative NSAIDs administration could be associated with a better outcome.

  1. Demaria Sandra, Pikarsky Eli, Karin Michael, Coussens Lisa M., Chen Yen-Ching, El-Omar Emad M., Trinchieri Giorgio, Dubinett Steven M., Mao Jenny T., Szabo Eva, Krieg Arthur, Weiner George J., Fox Bernard A., Coukos George, Wang Ena, Abraham Robert T., Carbone Michele, Lotze Michael T., Cancer and Inflammation: Promise for Biologic Therapy : , 10.1097/cji.0b013e3181d32e74
  2. Gibson Patrick H., Croal Bernard L., Cuthbertson Brian H., Small Gary R., Ifezulike Adaeze I., Gibson George, Jeffrey Robert R., Buchan Keith G., El-Shafei Hussein, Hillis Graham S., Preoperative neutrophil-lymphocyte ratio and outcome from coronary artery bypass grafting, 10.1016/j.ahj.2007.06.043
  3. Azab B, Chainani V, Shah N, McGinn JT. Neutrophil-lymphocyte ratio as a predictor of major adverse cardiac events among diabetic population: a 4-year follow-up study. Angiology. 2012. (in press).
  4. Hung Hsin-Yuan, Chen Jinn-Shiun, Yeh Chien Yuh, Changchien Chung-Rong, Tang Reiping, Hsieh Pao-Shiu, Tasi Wen-Sy, You Jeng-Fu, You Yau-Tong, Fan Chung-Wei, Wang Jeng-Yi, Chiang Jy-Ming, Effect of preoperative neutrophil–lymphocyte ratio on the surgical outcomes of stage II colon cancer patients who do not receive adjuvant chemotherapy, 10.1007/s00384-011-1192-x
  5. Tomita M, Shimizu T, Ayabe T, Yonei A, Onitsuka T. Preoperative neutrophil to lymphocyte ratio as a prognostic predictor after curative resection for non-small cell lung cancer. Anticancer Res. 2011;31(9):2995–8.
  6. Sharaiha Reem Z., Halazun Karim J., Mirza Farooq, Port Jeffrey L., Lee Paul C., Neugut Alfred I., Altorki Nasser K., Abrams Julian A., Elevated Preoperative Neutrophil:Lymphocyte Ratio as a Predictor of Postoperative Disease Recurrence in Esophageal Cancer, 10.1245/s10434-011-1754-8
  7. Kim H.S., Han K.H., Chung H.H., Kim J.W., Park N.H., Song Y.S., Kang S.B., Neutrophil to lymphocyte ratio for preoperative diagnosis of uterine sarcomas: A case-matched comparison, 10.1016/j.ejso.2010.05.004
  8. Garcea G., Ladwa N., Neal C. P., Metcalfe M. S., Dennison A. R., Berry D. P., Preoperative Neutrophil-to-Lymphocyte Ratio (NLR) is Associated with Reduced Disease-free Survival Following Curative Resection of Pancreatic Adenocarcinoma, 10.1007/s00268-011-0984-z
  9. Azab Basem, Bhatt Vijaya R., Phookan Jaya, Murukutla Srujitha, Kohn Nina, Terjanian Terenig, Widmann Warren D., Usefulness of the Neutrophil-to-Lymphocyte Ratio in Predicting Short- and Long-Term Mortality in Breast Cancer Patients, 10.1245/s10434-011-1814-0
  10. Keizman Daniel, Ish-Shalom Maya, Huang Peng, Eisenberger Mario A., Pili Roberto, Hammers Hans, Carducci Michael A., The association of pre-treatment neutrophil to lymphocyte ratio with response rate, progression free survival and overall survival of patients treated with sunitinib for metastatic renal cell carcinoma, 10.1016/j.ejca.2011.09.001
  11. Proctor Michael J., Morrison David S., Talwar Dinesh, Balmer Steven M., Fletcher Colin D., O’Reilly Denis St.J., Foulis Alan K., Horgan Paul G., McMillan Donald C., A comparison of inflammation-based prognostic scores in patients with cancer. A Glasgow Inflammation Outcome Study, 10.1016/j.ejca.2011.03.028
  12. Burn John, Gerdes Anne-Marie, Macrae Finlay, Mecklin Jukka-Pekka, Moeslein Gabriela, Olschwang Sylviane, Eccles Diane, Evans D Gareth, Maher Eamonn R, Bertario Lucio, Bisgaard Marie-Luise, Dunlop Malcolm G, Ho Judy WC, Hodgson Shirley V, Lindblom Annika, Lubinski Jan, Morrison Patrick J, Murday Victoria, Ramesar Raj, Side Lucy, Scott Rodney J, Thomas Huw JW, Vasen Hans F, Barker Gail, Crawford Gillian, Elliott Faye, Movahedi Mohammad, Pylvanainen Kirsi, Wijnen Juul T, Fodde Riccardo, Lynch Henry T, Mathers John C, Bishop D Timothy, Long-term effect of aspirin on cancer risk in carriers of hereditary colorectal cancer: an analysis from the CAPP2 randomised controlled trial, 10.1016/s0140-6736(11)61049-0
  13. Rothwell Peter M, Fowkes F Gerald R, Belch Jill FF, Ogawa Hisao, Warlow Charles P, Meade Tom W, Effect of daily aspirin on long-term risk of death due to cancer: analysis of individual patient data from randomised trials, 10.1016/s0140-6736(10)62110-1
  14. Rothwell Peter M, Wilson Michelle, Price Jacqueline F, Belch Jill FF, Meade Tom W, Mehta Ziyah, Effect of daily aspirin on risk of cancer metastasis: a study of incident cancers during randomised controlled trials, 10.1016/s0140-6736(12)60209-8
  15. Rothwell Peter M, Price Jacqueline F, Fowkes F Gerald R, Zanchetti Alberto, Roncaglioni Maria Carla, Tognoni Gianni, Lee Robert, Belch Jill FF, Wilson Michelle, Mehta Ziyah, Meade Tom W, Short-term effects of daily aspirin on cancer incidence, mortality, and non-vascular death: analysis of the time course of risks and benefits in 51 randomised controlled trials, 10.1016/s0140-6736(11)61720-0
  16. &NA;, Practice Guidelines for Acute Pain Management in the Perioperative Setting : An Updated Report by the American Society of Anesthesiologists Task Force on Acute Pain Management, 10.1097/aln.0b013e31823c1030
  17. De Oliveira Gildasio S., Agarwal Deepti, Benzon Honorio T., Perioperative Single Dose Ketorolac to Prevent Postoperative Pain : A Meta-Analysis of Randomized Trials, 10.1213/ane.0b013e3182334d68
  18. Forget Patrice, Vandenhende Julie, Berliere Martine, Machiels Jean-Pascal, Nussbaum Benoît, Legrand Catherine, De Kock Marc, Do Intraoperative Analgesics Influence Breast Cancer Recurrence After Mastectomy? A Retrospective Analysis : , 10.1213/ane.0b013e3181d2ad07
  19. M Retsky M, Rogers R, Demicheli R, Hrushesky W, Gukas I, Vaidya JS, Baum M, Forget P, DeKock M, Pachmann K. NSAID analgesic ketorolac used perioperatively may suppress earlybreast cancer relapse: something for nothing in breast cancer? [Abstract] San Antonio Breast Cancer Symposium Dec 6–10, 2011. San Antonio, TX, USA.
  20. Yakar Ilan, Melamed Rivka, Shakhar Guy, Shakhar Keren, Rosenne Ella, Abudarham Naphtali, Page Gayle G., Ben-Eliyahu Shamgar, Prostaglandin E2 Suppresses NK Activity In Vivo and Promotes Postoperative Tumor Metastasis in Rats, 10.1245/aso.2003.08.017
  21. Poncelet Alain J., Cornet Julien, Coulon Corinne, Collard Philippe, Noirhomme Philippe, Weynand Birgit, Intra-tumoral vascular or perineural invasion as prognostic factors for long-term survival in early stage non-small cell lung carcinoma☆, 10.1016/j.ejcts.2008.01.060
  22. Rutgers E.J.Th., Guidelines to assure quality in breast cancer surgery, 10.1016/j.ejso.2005.02.008
  23. Birido N., Geraghty J.G., Quality control in breast cancer surgery, 10.1016/j.ejso.2005.02.009
  24. Goldhirsch A., Glick J. H., Gelber R. D., Coates A. S., Thürlimann B., Senn H.-J., Meeting Highlights: International Expert Consensus on the Primary Therapy of Early Breast Cancer 2005, 10.1093/annonc/mdi326
  25. Goldhirsch A., Wood W. C., Gelber R. D., Coates A. S., Thurlimann B., Senn H. - J., , Progress and promise: highlights of the international expert consensus on the primary therapy of early breast cancer 2007, 10.1093/annonc/mdm271
  26. Lee Marie Catherine, Jagsi Reshma, Postmastectomy Radiation Therapy: Indications and Controversies, 10.1016/j.suc.2007.01.011
  27. Smith Benjamin D., Smith Grace L., Haffty Bruce G., Postmastectomy Radiation and Mortality in Women With T1-2 Node-Positive Breast Cancer, 10.1200/jco.2005.05.100
  28. Tisi Gennaro M., Friedman Paul J., Peters Richard M., Pearson Grif, Carr David, Lee Robert E., Selawry Oleg, Clinical Staging of Primary Lung Cancer, 10.1164/arrd.1983.127.5.659
  29. MacLennan Steven, Imamura Mari, Lapitan Marie C., Omar Muhammad Imran, Lam Thomas B.L., Hilvano-Cabungcal Ana M., Royle Pam, Stewart Fiona, MacLennan Graeme, MacLennan Sara J., Dahm Philipp, Canfield Steven E., McClinton Sam, Griffiths T.R. Leyshon, Ljungberg Börje, N’Dow James, Systematic Review of Perioperative and Quality-of-life Outcomes Following Surgical Management of Localised Renal Cancer, 10.1016/j.eururo.2012.07.028
  30. Mandrekar Sumithra J., Qi Yingwei, Hillman Shauna L., Allen Ziegler Katie L., Reuter Nicholas F., Rowland Kendrith M., Kuross Steven A., Marks Randolph S., Schild Steven E., Adjei Alex A., Endpoints in Phase II Trials for Advanced Non-small Cell Lung Cancer, 10.1097/jto.0b013e3181c0a313
  31. Ginsberg Robert J., Rubinstein Lawrence V., Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer, 10.1016/0003-4975(95)00537-u
  32. Concato John, The Risk of Determining Risk with Multivariable Models, 10.7326/0003-4819-118-3-199302010-00009
  33. Waymack JP, Flescher E, Venkatraman J, Fernandes G, Guzman RF, Yurt RW, Mason AD Jr, Pruitt BA Jr. Effect of prostaglandin E in multiple experimental models. VIII. Effect on host response to metastatic tumor. J Surg Oncol. 1991;48(4):239–45.
  34. Okuno Kiyotaka, Jinnai Hiroki, Lee Yung Sun, Nakamura Katsuhito, Hirohata Takeshi, Shigeoka Hironori, Yasutomi Masayuki, A high level of prostaglandin E2 (PGE2) in the portal vein suppresses liver-associated immunity and promotes liver metastases, 10.1007/bf00312380
  35. Singh Balraj, Lucci Anthony, Role of Cyclooxygenase-2 in Breast Cancer, 10.1006/jsre.2002.6532
  36. Waymack J. Paul, Flescher Eliezer, Venkatraman Jaya, Fernandes Gabriel, Guzman Rey F., Yurt Roger W., Mason Arthur D., Pruitt Basil A., Effect of prostaglandin E in multiple experimental models. VIII. effect on host response to metastatic tumor, 10.1002/jso.2930480406
  37. Melamed Rivka, Rosenne Ella, Shakhar Keren, Schwartz Yossi, Abudarham Naphtali, Ben-Eliyahu Shamgar, Marginating pulmonary-NK activity and resistance to experimental tumor metastasis: suppression by surgery and the prophylactic use of a β-adrenergic antagonist and a prostaglandin synthesis inhibitor, 10.1016/j.bbi.2004.07.004
  38. Ostrand-Rosenberg S., Sinha P., Myeloid-Derived Suppressor Cells: Linking Inflammation and Cancer, 10.4049/jimmunol.0802740
  39. ELSTON C.W., ELLIS I.O., pathological prognostic factors in breast cancer. I. The value of histological grade in breast cancer: experience from a large study with long-term follow-up, 10.1111/j.1365-2559.1991.tb00229.x
  40. Forget Patrice, Tombal Bertrand, Scholtès Jean-Louis, Nzimbala Jolio, Meulders Catherine, Legrand Catherine, Van Cangh Paul, Cosyns Jean-Pierre, De Kock Marc, Do intraoperative analgesics influence oncological outcomes after radical prostatectomy for prostate cancer? : , 10.1097/eja.0b013e32834b7d9a
  41. Bischofs E, Lubs D, Fritzsche F, Meyer AS, Bruckner T, Sohn C, Eichbaum MH. In vitro blockade of adhesion of breast cancer cells to endothelial cells using anti-inflammatory drugs. Anticancer Res. 2012;32(3):767–71.
  42. Li X, Gao L, Cui Q, Gary B D, Dyess D L, Taylor W, Shevde L A, Samant R S, Dean-Colomb W, Piazza G A, Xi Y, Sulindac inhibits tumor cell invasion by suppressing NF-κB-mediated transcription of microRNAs, 10.1038/onc.2011.655
  43. Barlow Meade, Edelman Morris, Glick Richard D., Steinberg Bettie M., Soffer Samuel Z., Celecoxib inhibits invasion and metastasis via a cyclooxygenase 2–independent mechanism in an in vitro model of Ewing sarcoma, 10.1016/j.jpedsurg.2012.03.031
Bibliographic reference Forget, Patrice ; Machiels, Jean-Pascal ; Coulie, Pierre G. ; Berlière, Martine ; Poncelet, Alain ; et. al. Neutrophil:Lymphocyte Ratio and Intraoperative Use of Ketorolac or Diclofenac are Prognostic Factors in Different Cohorts of Patients Undergoing Breast, Lung, and Kidney Cancer Surgery. In: Annals of Surgical Oncology, Vol. 20, no. Suppl 3, p. S650-660 (2013)
Permanent URL http://hdl.handle.net/2078.1/133902