Elevated Neutrophil-to-Lymphocyte Ratio as a Prognostic Factor in Primary Central Nervous System Lymphoma

Background Primary central nervous system lymphoma (PCNSL) is a rare form of non-Hodgkin lymphoma that represents 4–7% of all brain tumors. Several bodies of literature show that preoperative hematological values correlate with the prognosis of solid malignancies including those of the CNS. This study aimed to study the prognostic value of preoperative neutrophil-to-lymphocyte ratio (NLR) in a retrospective analysis of patients presenting with biopsy proven primary CNS lymphoma. Methods Preoperative complete blood counts (CBC) were collected for PCNSL patients who went through surgical resection (n = 55). Clinical information, such as demographic information, imaging characteristics, and clinical follow-up, was acquired. Cox proportional hazard models, ROC curves, and Kaplan-Meier curves were created to evaluate overall survival (OS) and recurrence-free survival (RFS). Results Univariate cox regression analysis showed how the NLR is significantly correlated with OS and RFS (P = .002, P = .006 respectively). In multivariate cox regression analysis, NLR is prognostically significant for OS and RFS (P = .006, P = .001 respectively). The ROC curve analyzing NLR for OS had an area of 0.627 and had an optimal cutoff value of 6.000. Using the NLR cutoff value of 6 in Kaplan-Meier analysis for RFS, the NLR was significant in predicting unfavorable OS in PCNSL patients (P = .0297). Conclusions A higher NLR was associated with poor OS and RFS in PCNSL patients. Further investigation must be conducted to validate the results and determine the optimal cutoff value for NLR in PCNSL patients.