Pre-Operative Measures of Systemic Inflammation Predict Survival After Surgery for Primary Lung Cancer

Area of Science:

• Oncology
• Inflammation Research
• Surgical Outcomes

Background:

• Measures of systemic inflammation (MSIs) are established prognostic markers in lung cancer.
• Limited research exists on MSIs specifically in patients undergoing curative-intent resection for non-small cell lung cancer (NSCLC).
• Targeting inflammatory pathways presents a potential novel therapeutic strategy in lung cancer treatment.

Purpose of the Study:

• To investigate the impact of various MSIs on survival outcomes in patients with NSCLC undergoing curative-intent resection.
• To identify specific MSIs that are independently associated with overall survival in this cohort.

Main Methods:

• A multicentre retrospective review of 5029 patients who underwent primary lung cancer resection between 2012 and 2018.
• Assessment of multiple MSIs including neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), systemic immune inflammation index (SII), advanced lung cancer inflammation index (ALI), prognostic nutritional index (PNI), and haemoglobin albumin lymphocyte platelet (HALP) score.
• Cox regression analysis was employed to determine the association between MSIs and overall survival.

Main Results:

• All assessed MSIs demonstrated a significant association with overall survival on univariable analysis.
• Multivariable Cox regression identified lower ALI (continuous and dichotomous) as independently associated with reduced overall survival (P = .049 and P < .001, respectively).
• The study included 5029 patients, with a 90-day mortality rate of 3.7%.

Conclusions:

• MSIs are significant factors influencing survival after lung resection for NSCLC with curative intent.
• The advanced lung cancer inflammation index (ALI) emerged as an independent predictor of long-term outcomes.
• Further research is warranted to explore the clinical utility of MSIs in managing primary lung cancer patients.