Prognostic value of pretreatment procalcitonin and neutrophil– lymphocyte ratio in extensive-stage small-cell lung cancer

Purpose: To investigate the influence of pretreatment neutrophil-to-lymphocyte ratio (NLR) and procalcitonin (PCT) on progression-free survival (PFS) in extensive-stage small-cell lung cancer (SCLC) patients. Methods A total of 100 extensive-stage SCLC patients were enrolled in our study. Patients were stratified according to the median values of pretreatment NLR and PCT levels: low NLR group (NLR ≤ 3.17), high NLR group (NLR༞3.17), low PCT group (PCT ≤ 0.06; ng/ml), high PCT group (PCT༞0.06; ng/ml). The Kaplan-Meier method and multivariable Cox regression model were used to reveal the prognostic effects of pretreatment NLR and PCT on PFS. Results The median PFS of the total extensive-stage SCLC patients was 6.0 months. The median PFS of low pretreatment NLR group (NLR ≤ 3.17) was not significantly different from that of high pretreatment NLR group (6.2 months vs 5.8 months; P = 0.675). Patients with low pretreatment PCT (PCT ≤ 0.06; ng/ml) had significantly better PFS than patients with high pretreatment PCT (PCT༞0.06; ng/ml) (6.9 months vs 5.7 months; P = 0.043). With the multivariable Cox regression analysis, the response to first-line chemotherapy (P ≤ 0.001) and pretreatment PCT (HR = 0.516; 95%CI 0.326–0.817; P = 0.005) were identified as independent factors associated with PFS. Conclusion Pretreatment PCT is an independent factor associated with PFS in extensive-stage SCLC patients treated with first-line chemotherapy, but pretreatment NLR reflects no significant prognostic value in our study.