Supervisors info:
Κωνσταντίνος Ν. Συρίγος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Αικατερίνη Πολίτη, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Νικόλαος Καβαντζάς, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Summary:
Introduction. Lung cancer (LC) remains the leading cause of cancer-related death worldwide, despite significant progress in early diagnosis, discovery of novel driver mutations and the development of new personalized therapies. As shown in recent studies, inflammation plays a key role in lung cancer pathogenesis and evolution, while the potential prognostic and predictive value of various inflammation markers in different disease stages is being extensively studied.
Aim. We herein aimed to further evaluate the potential prognostic value of a new inflammation marker (ALI, Advanced Lung Cancer Inflammation Index = BMI x Alb / NLR), which combines previous markers of systematic inflammation with markers of nutrition or cachexia at the time of LC diagnosis.
Materials and Methods. The medical records of 67 patients, diagnosed with LC in Sismanoglio Athens General hospital, within a two-year period (January 2016-January 2018) were retrospectively studied. Demographic, clinicopathological and laboratory features of patients, including pre-treatment ALI, were recorded and correlated with prognosis (overall survival, OS).
Results. A total of 67 patients were included with a mean age of 60 (± 8) years. The majority of cases were men (39/67,58.2 %), with positive smoking history (62/67, 92.5%), performance status (PS) 1-2 (43/67, 64.2%) and disease stage IV (54/67, 80.6%). Adenocarcinoma was the commonest histological type observed (19/67, 28.5%). Values of ALI ranged from 7.8 to 37.2 (mean: 21±6). The cut-off point of ALI was 19 (based on ROC curve analysis) and patients were divided into two groups: those with ALI ≤19 and those with ALI >19. In univariate analysis, PS and the presence of metastatic disease, as well as ALI values ≤19, were all correlated with reduced survival (p=0.002, p=0.028 and p=0.018, respectively). In multivariate analysis, PS was the only parameter that retained its statistically significant correlation with an adverse prognosis (p=0.048), although its prognostic significance was increased when combined with ALI.
Conclusions. The new prognostic marker ALI, is both practical and reliable, and may suggest, when its values are low, high levels of systemic inflammation and a worse prognosis. When combined with other prognostic factors, such as PS, it may be used for improved prediction of patients’ survival. Additional prospective studies are warranted to further validate the prognostic significance of this promising biomarker and expand its use in routine clinical practice.
