NLR-fat/NLR-muscle mass grading system significantly predicts survival in cancer patients: a multicenter cohort study

Cancer is a major public health challenge worldwide. Effective prognostic tools are essential to optimize treatment strategies and improve patient outcomes. The aim of this study was to develop an innovative grading system that combines the neutrophil-to-lymphocyte ratio (NLR) with body fat mass and muscle mass (NLR-fat/NLR-muscle mass grading system) to better predict patient survivals.

This multicenter prospective cohort study included 4417 cancer patients for data analysis. A 3 × 3 matrix was constructed based on NLR and fat mass/muscle mass in men and women patients. The Cox regression models were used to evaluate the prognostic risk of 9 groups of patients and the patients were divided into 4 grades according to the hazard ratios (HR) value of overall survival (OS). The Kaplan-Meier curve was used to evaluate the survival difference of patients in different grades. The time-dependent receiver operating characteristic curve (ROC) and C index were used to compare the predictive ability of the grading system.

In the study, the mean age of patients was 58.05±10.34 years. The Kaplan-Meier curve showed that the higher the NLR-fat/NLR-muscle mass grade, the worse the survival of both men and women patients (p < 0.001). Cox regression analysis showed that the NLR-fat/NLR-muscle mass grade was an independent risk factor for OS of cancer patients. The results of the subgroup analysis confirmed the broad applicability of the NLR-fat/NLR-muscle mass grading system in different patient populations. In addition, sensitivity analysis and internal validation further confirmed the robustness of the grading system.

The NLR-fat/NLR-muscle mass grading system provides a comprehensive and effective approach for predicting survival in cancer patients.