Neutrophil-Lymphocyte Ratio Predicts Survival in Terminal Cancer Patients

Background: Neutrophil-lymphocyte count ratio (NLR) is a prognostic factor in cancer, although its prognostic significance in terminally ill cancer patients is not clear. Objective: We investigated the association of NLR with survival in patients with terminal cancer. Methods: We retrospectively investigated 205 consecutive patients with terminal cancer admitted to a palliative care unit during 2014. Results: The median value of NLR was 9.7. In univariable analysis, NLR of 10 or more was significantly associated with shorter survival and NLR further discriminated survival of each palliative prognostic index (PPI) group. In multivariable analysis, increased NLR (>= 10) was associated with shorter survival (hazards ratio [HR] 1.54, p<0.005), along with poor performance status (HR 1.55, p < 0.011), high PPI score (HR 1.59, p<0.003), and hyperbilirubinemia (HR 1.84, p < 0.001). Conclusion: Our results suggest that elevated NLR was an independent prognostic factor for poor survival in patients with terminal cancer.