The effect of neutrophil lymphocyte ratio on prognosis in patients with neuroblastoma

Objectives: Recent studies have shown that the neutrophil-lymphocyte ratio (NLR) is a new inflammatory marker that is effective in determining the prognosis of many solid tumors, chemotherapy responses, survival and their recurrence rate. Additionally, neuroblastoma is the most common solid tumor in childhood, except for the central nervous system, since, there is no such study yet have been conducted on children. Therefore, we performed a retrospective study to investigate the effect of neutrophil lymphocyte and platelet lymphocyte ratio (PLR) on risk factors and prognosis in these patients. Materials and Methods: In this study 246 pediatric patients whith neuroblastoma who were diagnosed, treated and followed up during 2000-2021 in Faculty of Medicine, Department of Pediatric Oncology Chukurova University, were included. The files of the patients included in the study were reviewed retrospectively. Whereas, required information of patients was obtained from archive files, to approach the data base of the patients Mergentech hospital program and E-Nabız system was used. Results: Among, 246 patients included in our study, 134 (54.5%) were boys and 112 (45.5%) were girls, respectively. The age range at the time of diagnosis of the patients was between 0 and 180 months, and the mean age at diagnosis was 27 months. In the patients included in our study, the medium value for NLR was found to be 1,06, for PLR it was found as 92, respectively. The relationship of NLR values with age, stage, risk group and Shimada was found to be statistically signifıcant with (p <0,001), wheres, VMA (p=0,006) was also depicted the signifıcant value. Likewise, the relationship of TLR values with age (p<0.001), stage (p = 0.022), Shimada (p = 0.004), N – Myc amplification (p = 0.039) was found to be statistically significant as well. However, survival analysis showed that, no statistically significant difference was observed among the higher and lower values of NLR. The results further indicates the survival rates were noticed lower in the higher values of NLR as compared to lower values (10-year overall survival 55% vs. 49%, 10-year event-free survival 54% vs. 43%). Conclusions: According to the results of our study, it was revealed that the pre-treatment evaluation of NLR and TLR values in patients with neuroblastoma may be instructive inrespect of prognosis and risk group. Keyword: Neuroblastom, neutrophil lymphocyte ratio, trombocyte lymphocyte ratio