Akciğer Kanseri Nedeniyle Ameliyat Edilen Yaşlı Hastalarda Sağkalım ile İnflamatuvar ve Beslenme Belirteçleri Arasındaki İlişki

Abstract

Amaç: Günümüzde yaşlı nüfusta kanser insidansında ve kansere bağlı ölümlerde artış görülmektedir. Bu çalışmanın amacı küçük hücreli dışı akciğer kanseri (KHDAK) tanılı olan yaşlı hastalarda nötrofil lenfosit oranı (NLO) ve prognostik beslenme indeksi (prognostic nutritional index, PNI) düzeylerinin sağkalım oranı üzerindeki etkisinin değerlendirilmesidir. Gereç ve Yöntemler: Bu çalışmaya 2012 ve 2018 yılları arasında KHDAK nedeniyle opere edilmiş olan toplam 73 hasta (≥70 yaş) dahil edildi. Hasta kayıtları geriye dönük olarak analiz edildi. NLO değeri, kan nötrofil sayısı/lenfosit sayısı formülü ile hesaplandı. NLR için kesim değeri 2,5 olarak kabul edildi. PNI değeri, 10 x serum albümini (g/dL) + 0,005 x toplam lenfosit sayısı (milimetre başına) şeklinde hesaplandı. 50'nin altındaki PNI değerleri düşük olarak kabul edildi. Bulgular: Hastaların ortalama yaşı 74,15±3,23 yıl, 59 (%80,8) hasta erkek ve 14'ü (%19,2) hasta kadındı. PNI (p=0,354) ve NLO (p=0,483) ile postoperatif komplikasyon arasında istatistiksel olarak anlamlı bir ilişki saptanmadı. Postoperatif mortalite de PNI (p=0,188) ve NLO (p=0,465) ile anlamlı olarak ilişkili değildi. NLO <2,5 olan hastalarda 1-, 3- ve 5-yıllık sağkalım oranları sırasıyla %86,0, %86,1 ve %78,3 iken bu oranlar NLR >2,5 olan hastalar için sırasıyla %76,9, %65,2 ve %24,8 idi (p=0,028). Sonuç: Sonuçlar KHDAK olan yaşlı hastalarda NLO ile sağkalım oranları arasında anlamlı bir ilişki olduğunu ortaya koydu. NLO, KHDAK hastalarında tedavi kararlarını yönlendirmek ve optimize etmek için rutin klinik uygulamaya dahil edilebilecek ucuz, kolay ölçülebilir ve tekrarlanabilir bir belirteç olarak kabul edilebilir.

Keywords

• Akciğer kanseri
• NLR
• PNI
• postoperatif mortalite
• yaşlı nüfus

The Association between Inflammatory and Nutritional Markers and Survival in Elderly Patients Operated for Lung Cancer

Abstract

Aim: Today, there is an increase in cancer incidence and cancer-related deaths in the elderly population. This study aimed to evaluate the impact of neutrophil-to-lymphocyte ratio (NLR) and prognostic nutritional index (PNI) levels on the survival rate in elderly patients diagnosed with non-small cell lung cancer (NSCLC). Material and Methods: A total of 73 patients (aged ≥70 years) who operated for NSCLC between 2012 and 2018 were included in this study. Patient records were analyzed retrospectively. The NLR value was calculated with the blood neutrophil count/lymphocyte count formula. The cut-off value for NLR was considered as 2.5. The PNI value was calculated as 10 x serum albumin (g/dL) + 0.005 × total lymphocyte count (per millimeter). PNI values lower than 50 were considered as low. Results: The mean age of the patients was 74.15±3.23 years, 59 (80.8%) patients were male and 14 (19.2%) were female. No statistically significant relation of postoperative complication was noted with PNI (p=0.354) and NLR (p=0.483). Postoperative mortality was not significantly associated with PNI (p=0.188) and NLR (p=0.465). For patients with NLR <2.5, 1-, 3-, and 5-year survival rates were at 86.0%, 86.1%, and 78.3%, respectively, while these rates were at 76.9%, 65.2%, and 24.8%, respectively, for patients with NLR >2.5 (p=0.028). Conclusion: Results revealed a significant association of NLR with survival rates in elderly patients with NSCLC. NLR can be considered inexpensive, easily measurable, and reproducible marker that can be incorporated into routine clinical practice for guiding and optimizing treatment decisions in patients with NSCLC.

Keywords

• Lung cancer
• elderly population
• NLR
• PNI
• postoperative mortality

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