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August 30, 2026In VivoOpen Access

Pan-cancer Evaluation of the Neutrophil-to-Lymphocyte Ratio as a Prognostic Marker Across Six Major Solid Tumors

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Authors

GCGuilan CaiCapital Medical UniversityXZXIAO ZHANGCapital Medical UniversityHZHeyang ZhangLeiden University

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Implication

Cohort study reveals elevated neutrophil-to-lymphocyte ratio predicts worse survival across six solid tumors, highlighting its utility for individualized prognostic risk stratification.

Key Points

  • To evaluate the prognostic accuracy of the neutrophil-to-lymphocyte ratio across six major solid malignancies and formulate a clinical nomogram for overall survival risk prediction.
  • Analyzed 14,425 patients with lung, gastric, colorectal, liver, brain, or breast cancer from the INSCOC registry, split randomly into training (n=10,098) and validation (n=4,327) cohorts.
  • Compared six inflammation indices against overall survival using Harrell's C-index, time-dependent ROC curves, Kaplan-Meier methods, restricted cubic splines, and multivariable Cox proportional hazards models.
  • Developed a pragmatic nomogram integrating the neutrophil-to-lymphocyte ratio with routinely available clinical variables, assessing performance via internal calibration analysis.
  • Elevated neutrophil-to-lymphocyte ratio independently predicted worse overall survival in a progressive manner (p < 0.001) and exhibited greater prognostic discrimination than competing inflammation indices.
  • Associations between higher neutrophil-to-lymphocyte ratio and increased mortality remained consistent across age, sex, comorbidity, and treatment subgroups.
  • The developed nomogram demonstrated acceptable calibration for predicting 1-, 3-, and 5-year overall survival across cohorts.

Cite This Study

Cai et al. (2026) studied this question.

synapsesocial.com/papers/6a93f0ce6c1a8fb52e79d4f4https://doi.org/10.21873/invivo.14413
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Abstract 7667: Neutrophil to lymphocyte ratio (NLR) as an indicator of tumor immune status in non-small cell lung cancer2024
  2. 2Prognostic assessment of baseline neutrophil-to-lymphocyte ratio in locally advanced and metastatic lung cancer: A retrospective analysis from a tertiary care center in Northeast India2024
  3. 3Neutrophil-Lymphocyte Ratio (NLR) as a Prognostic Marker in Advanced Lung Cancer Patients Undergoing First-Line Treatment2024
  4. 4Prognostic Role of Neutrophil-to-Lymphocyte Ratio in Solid Tumors: A Systematic Review and Meta-Analysis2014 · 3,400 citations
  5. 5The Evaluation of Diagnostic, Prognostic, and Predictive Role of Hematologic Inflammatory Indices NLR , PLR , and LMR in Common Solid Tumors2025 · 12 citations