Postoperative short-term prognostic factors in patients with primary lung cancer who undergo lobectomy: a study on the prognostic predictors of early postoperative recurrence

Background: Lung cancer is among the most common types of cancers worldwide, and surgery can be a curative treatment option for this condition. However, some patients experience postoperative recurrence. Hence, predicting early postoperative recurrence to improve patient prognosis is important. This study aimed to determine the usefulness of nutritional inflammation indexes in predicting the prognosis of early recurrence after lung cancer surgery.

Methods: A retrospective cohort study was conducted on 310 patients with primary lung cancer who underwent lung lobectomy at Jikei University Hospital from January 1, 2013, to December 31, 2017. The prognostic nutrition index (PNI), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and modified Glasgow prognostic score (mGPS) were calculated. The patients were classified into the high and low groups based on the receiver operating characteristic (ROC) curves. Furthermore, the association between these indexes and postoperative recurrence was analyzed via univariate analysis and using the Kaplan-Meier method.

Results: The mean age of the patients was 67.0 years, and the male-to-female ratio was 199:111. The mean observation period was 30.6 months. Patients with a low NLR and mGPS had a significantly longer 5-year recurrence-free survival than those with a high NLR and mGPS (P=0.045 and 0.02, respectively). Patients with a low PNI had a significantly higher 1-year recurrence rate than those with a high PNI (P=0.007).

Conclusions: The PNI is associated with 1-year recurrence, and NLR and mGPS are considerably associated with 5-year postoperative recurrence in patients with lung cancer. Hence, these nutritional inflammatory indices can be useful in predicting postoperative recurrence.