Prognostic Values of the De Ritis Ratio and Other Inflammatory Markers in Patients with Extensive-Stage Small Cell Lung Cancer

Abstract

Objectives: We aimed to evaluate the prognostic significances of the aspartate aminotransferase-to-alanine aminotransferase ratio (the De Ritis ratio) and other some inflammatory markers on survival in extensive-stage small cell lungcancer (ES-SCLC).Methods: A total of 135 patients diagnosed with ES-SCLC in between 2017 and 2020 were included. The pre-treatment values of the De Ritis ratio, the neutrophil-lymphocyte ratio (NLR), the platelet-lymphocyte ratio (PLR), and thepre-treatment levels of gamma-glutamyl transferase (GGT) and lactate dehydrogenase (LDH) were analyzed for theirrelationship with overall survival (OS). Optimal cutoff values were determined through receiver operating characteristic curves and survival probabilities were analyzed through the Kaplan–Meier method. Multivariate analyses wereperformed to investigate the prognostic significance of these parameters for ES-SCLC.Results: The median age of the patients at diagnosis was 62.2 (min: 42.5–max: 86.6). The median follow-up time was8.94±8.02 months. The most common sites of metastasis at admission were bones (33%), followed by the liver (27%),the brain (23%), and the adrenal glands (17%). Median OS was 7.52 months (min: 0.2–max: 50.6). The De Ritis ratio andother inflammatory markers (NLR, PLR, and GGT) were not statistically significantly related with OS (p=0.40; 0.06; 0.29;and 0.49, respectively). Multivariate analyses indicated that only LDH (HR=1.001; p=0.012) was an independent prognostic factor.Conclusion: The De Ritis ratio and other systemic inflammatory markers are not predictive for prognosis in ES-SCLCpatients. There is a need for larger prospective studies to investigate the roles of potential biomarker candidates inpredicting prognosis in ES-SCLC.