Neutrophil-to-lymphocyte ratio is correlated to driver gene mutations in surgically-resected non-small cell lung cancer and its post-operative evolution impacts outcomes.

ABSTRACT BACKGROUND : We sought to evaluate prognostic value of neutrophil-to-lymphocyte ratio (NLR) in surgically resected non-small cell lung cancer (NSCLC) and its correlation to oncogenic drivers. We retrospectively reviewed data of patients who underwent anatomic lung resection for NSCLC and whose mutational status was known, from 4 department of thoracic surgery, over the period 2008 to 2019. Primary endpoints were overall survival (OS) and time to recurrence (TTR). Clinical and molecular factors were investigated in the univariate and multivariate analysis for their association with the primary endpoints. RESULTS : 2027 patients were included in the analysis. Correlations between NLR and OS (R2=0.21), NLR and TTR (R2=0.085) were significant (P In the univariable analysis, the median OS was 66 months (95% CI: 62.94 – 69.06) in case of pre-operative NLR ≤ 4.07 and 38 months (95% CI: 36.73 – 39.27) in case of pre-operative NLR > 4.07 (P 4.07 (P 4.07 and KRAS (Cramer's V = 0.082, P  CONCLUSIONS : Low pre-operative NLR is associated with longer OS in patients with resected NSCLC. Low pre-operative NLR is not associated with longer TTR in multivariate analysis. Correlation between the high NLR and KRAS/EGFR mutations were observed. MICROABSTRACT The prognostic value of NLR and its kinetic evolution in lung cancer patients undergoing surgery remains poorly studied. In this multi-centre retrospective study including 2027 patients, NLR was correlated with overall survival and time to recurrence. Low pre-operative NLR is associated with longer OS in patients with resected NSCLC.