The prognostic role of indicators of systemic inflammatory response in patients with glioblastoma

Abstract

Background: High-grade gliomas, among which glioblastomas are the most frequently observed histologic subtype, are the most common primary brain tumors in adults. The standard treatment for glioblastoma consists of maximal safe resection, followed by concomitant chemoradiotherapy. It was reported that inflammatory response plays a major role in malignancy, including tumor progression. This study aimed to determine the prognostic role of the neutrophil to lymphocyte ratio (NLR) and the thrombocyte to lymphocyte ratio (PLR)-both indicators of systemic inflammatory response (SIR)-in patients with glioblastoma. Methods: This study retrospectively evaluated 90 patients that were treated for glioblastoma. Results: Median follow-up time was 11.3 months (range: 1-70 months). The 1-year and 2-year overall survival rates were 55.2% and 19.5%, respectively. Univariate analysis showed that there wasn't a correlation between overall survival and gender (p=0.184), comorbid diseases (p=0.30), clinical presentation (p=0.884), or tumor lateralization (p=0.159). The prognostic factors that affected survival-other than SIR-were Eastern Cooperative Oncology Group (ECOG) performance status (p=0.003), and tumor localization (p=0.006). Multivariate analysis showed that overall survival was significantly correlated with SIR based on NLR (HR: 2.41), and ECOG performance status (HR: 1.53). Conclusions: These findings confirm that the NLR value obtained from peripheral blood prior to treatment can be used as a prognostic factor in patients with glioblastoma. It is known that a high NLR value (NLR-5) is indicative of aggressive disease with decreased survival; therefore, aggressive treatment modalities can be offered to this selected patient population.