A Cumulative Score Based on Preoperative Neutrophil-Lymphocyte Ratio and Fibrinogen in Predicting Overall Survival of Patients with Glioblastoma Multiforme.

OBJECTIVE

We conducted a retrospective analysis to explore the prognostic effect of the cumulative score based on neutrophil-lymphocyte ratio (NLR) and fibrinogen in patients with glioblastoma multiforme (GBM).

METHODS

The clinical data of patients with GBM from January 2014 to December 2017 in our hospital were retrospectively analyzed. X-tile software was used to identify the optimal cutoff points of NLR and fibrinogen in predicting prognosis of GBM. Fibrinogen-NLR (F-NLR) score was calculated as following: fibrinogen >3.4 g/dL and NLR >4.1 was identified as F-NLR score of 2, only 1 abnormal index was defined as F-NLR score of 1, and no abnormal indices were classified as F-NLR score of 0.

RESULTS

A total of 187 patients with primary GBM were enrolled in this study. Of these patients, 116 patients were men and 71 were women, and the mean age was 55 ± 13.55 years. The cutoffs of lymphocyte, NLR, fibrinogen, and platelet-lymphocyte ratio (PLR) identified by X-tile were 1.8 × 109/L, 4.1 × 109/L, 3.4 mg/dL, and 228.6. There were 87 patients with F-NLR score of 0, 50 patients with F-NLR score of 1, and 50 patients with F-NLR score of 2. In the univariate survival analysis, age, lymphocyte count, fibrinogen, NLR, PLR, F-NLR score of 2, chemotherapy, and radiotherapy were significant predictors of overall survival (OS) in patients with GBM (all P < 0.05). After excluding related parameters, F-NLR score of 2 (hazard ratio [HR], 2.103; 95% confidence interval [CI], 1.401-3.155; P < 0.001) and chemotherapy (HR, 0.650; 95% CI, 0.432-0.977; P = 0.038) were predictive factors of OS for patients with GBM. When stratified by extent of resection, age, and adjuvant chemotherapy and radiotherapy, F-NLR score maintained the prognostic value in patients with GBM (all P < 0.05).

CONCLUSIONS

F-NLR score of 2 was a risk predictor of prognosis for patients with GBM.