Neutrophil/Lymphocyte Ratio Is an Independent Prognostic Factor in Elderly Patients with High-Grade Gliomas

OBJECTIVE: The present study was performed to investigate the prognostic role of the preoperative neutrophil/lymphocyte ratio (NLR) in elderly patients with high-grade glioma. METHODS: We collected the data from elderly patients (age >= 65 years) who had been diagnosed with high-grade glioma in our hospital from December 2014 to January 2018. The preoperative NLR was evaluated in univariate and multivariate models to examine their effect on overall survival (OS). RESULTS: The study included 135 elderly patients (World Health Organization grade III, n = 22; grade IV, n = 113) with a mean age 70.61 +/- 4.60 years. The mean NLR was 3.98 +/- 3.28. The optimal NLR cutoff for predicting OS was 3. Of the 135 patients, 65 (48.1%) had a baseline NLR of >= 3 and 70 (51.9%) a baseline NLR <3. For patients with an NLR of >= 3 and NLR <3, the mean OS was 9.6 months and 17.1 months, respectively. The results showed that age, gender, tumor location, preoperative Karnofsky performance scale score, extent of resection (EOR), and postoperative adjuvant therapy were not associated with the NLR. The tumor grade, neutrophil count, and lymphocyte count were significantly associated with the NLR (P < 0.001). On univariate analysis, tumor grade, preoperative Karnofsky performance scale score >= 80, EOR, frontal tumor, adjuvant radiotherapy plus temozolomide, NLR of >= 3, and lymphocyte count of >= 1.6 x 10(9)/L were significantly associated with OS. On multivariate analysis, tumor grade, EOR, adjuvant radiotherapy plus temozolomide, NLR of >= 3, and lymphocyte count of >= 1.6 x 10(9)/L were still associated with OS after excluded related parameters. CONCLUSIONS: A high NLR was an unfavorable predictor of prognosis for elderly patients with high-grade glioma.