Preoperative lymphocyte-to-monocyte ratio < 4 was significantly associated with worse disease-specific survival in recurrent adrenocortical carcinoma (HR 4.18; 95% CI 1.18-14.76; P=.027).
Cohort (n=25)
Does preoperative LMR < 4 predict worse disease-specific survival in patients with recurrent adrenocortical carcinoma?
Preoperative LMR < 4 and TTR < 12 months are significant prognostic indicators for worse disease-specific survival in patients with recurrent adrenocortical carcinoma.
Hazard Ratio: 4.18 (95% CI 1.18–14.76)
Absolute Event Rate: 41% vs 71%
p-value: p=.027
BACKGROUND: Recurrent adrenocortical carcinoma (ACC) has a poor prognosis with minimal clinical and biochemical factors to guide management. The aim of this study was to evaluate the prognostic significance of systemic inflammatory response in patients with recurrent ACC. METHODS: Patients who underwent resection for recurrent ACC were retrospectively analyzed. Preoperative neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio (LMR), and mean platelet volume were calculated. RESULTS: Twenty-five patients (age at operation 52.2 ± 9.5 years) were identified. We observed a statistically significant shorter disease-specific survival (DSS) in patients with LMR less than 4 (41 ± 7.4 months vs 71 ± 12.3, P = .023) and male sex (26.6 ± 4.2 months vs 57.6 ± 9.5 months, P = .079), while time-to-recurrence (TTR) less than 12 months (40 ± 7.7 months vs 70.3 ± 13.1 months, P = .059) had a trend on univariate analysis for worse DSS. On multivariable analysis, LMR < 4 (hazard ratio HR 4.18; 95% confidence interval CI: 1.18-14.76; P = .027) and TTR less than 12 months (HR 2.77 95% CI: 1-7.62; P = .049) were found to be significantly associated with worse DSS. CONCLUSION: Preoperative LMR greater than 4 and TTR greater than 12 months are associated with longer DSS. Patients with LMR greater than 4 and TTR greater than 12 months may benefit from a more aggressive therapeutic approach and may require less frequent surveillance.
Gaitanidis et al. (2019) conducted a cohort in recurrent adrenocortical carcinoma (n=25). Preoperative lymphocyte-to-monocyte ratio (LMR) < 4 vs. LMR ≥ 4 was evaluated on disease-specific survival (DSS) (HR 4.18, 95% CI 1.18-14.76, p=.027). Preoperative lymphocyte-to-monocyte ratio < 4 was significantly associated with worse disease-specific survival in recurrent adrenocortical carcinoma (HR 4.18; 95% CI 1.18-14.76; P=.027).