The Association between Inflammatory and Nutritional Markers and Survival in Elderly Patients Operated for Lung Cancer

Aim: Today, there is an increase in cancer incidence and cancer-related deaths in the elderly population. This study aimed to evaluate the impact of neutrophil-to-lymphocyte ratio (NLR) and prognostic nutritional index (PNI) levels on the survival rate in elderly patients diagnosed with non-small cell lung cancer (NSCLC). Material and Methods: A total of 73 patients (aged >= 70 years) who operated for NSCLC between 2012 and 2018 were included in this study. Patient records were analyzed retrospectively. The NLR value was calculated with the blood neutrophil count/lymphocyte count formula. The cut-off value for NLR was considered as 2.5. The PNI value was calculated as 10 x serum albumin (g/dL) + 0.005 x total lymphocyte count (per millimeter). PNI values lower than 50 were considered as low. Results: The mean age of the patients was 74.15 +/- 3.23 years, 59 (80.8%) patients were male and 14 (19.2%) were female. No statistically significant relation of postoperative complication was noted with PNI (p=0.354) and NLR (p=0.483). Postoperative mortality was not significantly associated with PNI (p=0.188) and NLR (p=0.465). For patients with NLR <2.5, 1-, 3-, and 5-year survival rates were at 86.0%, 86.1%, and 78.3%, respectively, while these rates were at 76.9%, 65.2%, and 24.8%, respectively, for patients with NLR >2.5 (p=0.028). Conclusion: Results revealed a significant association of NLR with survival rates in elderly patients with NSCLC. NLR can be considered inexpensive, easily measurable, and reproducible marker that can be incorporated into routine clinical practice for guiding and optimizing treatment decisions in patients with NSCLC.