Medical sciences (Basel, Switzerland) · 2026
The Association Between Inflammatory Scores and Frailty Severity: An Exploratory Retrospective Analysis in Non-Small-Cell Lung Cancer Surgical Patients.
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Iacobescu Radu-Alexandru, Boiculese Vasile Lucian, Dodi Gianina, Lunguleac Tiberiu, Grigorescu Cristina, Antoniu Sabina
Аннотация
BACKGROUND: Frailty has been linked with systemic inflammation in elderly oncology patients. In this paper, we report the results of an analysis evaluating the association between blood cell biomarkers of inflammation and frailty in patients with operable non-small-cell lung cancer (NSCLC).
METHODS: A retrospective analysis was performed on patients undergoing surgery for NSCLC between March 2022 and March 2023. Frailty was assessed using the modified Frailty Index-5 (mFI-5) and 11 (mFI-11). Inflammation was evaluated using the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), and systemic immune-inflammation response index (SIRI), all calculated from preoperative assessments.
RESULTS: In this sample of surgical NSCLC patients (n = 106), frailty prevalence was 29.2% with mFI-11 and 17% with mFI-5. The log of the neutrophil-to-lymphocyte ratio (logNLR) emerged as the most significant predictor of frailty (OR of 3.13, 95% CI: 1.12-9.09, p = 0.03 for mFI-11 and 3.82, 95% CI: 1.28-11.11, p = 0.02 for FI-5). The platelet-to-lymphocyte ratio (PLR) was predictive only in the model assessing mFI-5. Furthermore, both the NLR and PLR showed an inverse linear correlation with frailty severity, a finding that remained consistent regardless of age, gender, disease stage, nutrition status, or comorbidity burden.
CONCLUSIONS: Frail patients with operable NSCLC exhibit distinct inflammatory response patterns compared with those observed in non-frail lung cancer patients. Using these biomarkers could help identify patients suitable for preoperative interventions that could improve their postoperative course. However, further studies are needed to explore these preliminary findings prospectively and to understand the causal relationship between the observed association with frailty status and severity.
METHODS: A retrospective analysis was performed on patients undergoing surgery for NSCLC between March 2022 and March 2023. Frailty was assessed using the modified Frailty Index-5 (mFI-5) and 11 (mFI-11). Inflammation was evaluated using the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), and systemic immune-inflammation response index (SIRI), all calculated from preoperative assessments.
RESULTS: In this sample of surgical NSCLC patients (n = 106), frailty prevalence was 29.2% with mFI-11 and 17% with mFI-5. The log of the neutrophil-to-lymphocyte ratio (logNLR) emerged as the most significant predictor of frailty (OR of 3.13, 95% CI: 1.12-9.09, p = 0.03 for mFI-11 and 3.82, 95% CI: 1.28-11.11, p = 0.02 for FI-5). The platelet-to-lymphocyte ratio (PLR) was predictive only in the model assessing mFI-5. Furthermore, both the NLR and PLR showed an inverse linear correlation with frailty severity, a finding that remained consistent regardless of age, gender, disease stage, nutrition status, or comorbidity burden.
CONCLUSIONS: Frail patients with operable NSCLC exhibit distinct inflammatory response patterns compared with those observed in non-frail lung cancer patients. Using these biomarkers could help identify patients suitable for preoperative interventions that could improve their postoperative course. However, further studies are needed to explore these preliminary findings prospectively and to understand the causal relationship between the observed association with frailty status and severity.