Prognostic impact of cancer inflammation prognostic index for non-small cell lung cancer

Abstract

Abstract Purpose: Cancer-inflammation prognostic index (CIPI) is calculated by multiplying the concentration of carcinoembryonic antigen by neutrophil-to-lymphocyte ratio. CIPI has been reported as a prognostic factor for colorectal cancer. Although carcinoembryonic antigen and neutrophil-to-lymphocyte ratio have been reported as prognostic factors for non-small cell lung cancer (NSCLC), it has not been investigated whether CIPI is a useful marker. Methods: We analyzed the prognostic factors, including CIPI, in 700 NSCLC patients treated by pulmonary resection. We also analyzed a subgroup of 482 patients with pathological stage I NSCLC. Result: CIPI>14.59 (P<.01), maximum standardized uptake value (SUVmax) >5.35 (P<.01), lymphatic invasion (P=.01), and pathological stage (P<.01) were significant factors for relapse-free survival (RFS) in multivariate analysis. SUVmax>5.35 (P<.01) and pathological stage (P<.01) were revealed as significant factors for overall survival in the multivariate analysis. In the subanalysis, CIPI>14.88 (P=.01) and SUVmax>5.07 (P<.01) were significant factors for RFS of pathological stage I NSCLC in multivariate analysis. Conclusion: CIPI was a significant factor for RFS in NSCLC patients treated surgically, even in those with pathological stage I disease. SUVmax was also a significant factor for RFS and overall survival in NSCLC patients treated surgically, and for RFS in patients with pathological stage I NSCLC. Trial registration: The Institutional Review Board of Kanazawa Medical University approved the protocol of this retrospective study (approval number: I392), and written informed consent was obtained from all patients