Neutrophil-to-lymphocyte ratio can predict outcome in extensive small cell lung cancer

Prognostic parameters for survival in SCLC

  • Gordana Drpa University Hospital Center Zagreb, Department for Lung Diseases Jordanovac
  • Maja Šutić Ruđer Bošković Institute
  • Jurica Baranašić Ruđer Bošković Institute
  • Marko Jakopović University Hospital Center Zagreb
  • Miroslav Samaržija University Hospital Center Zagreb
  • Suzana Kukulj University Hospital Center Zagreb
  • Jelena Knežević Ruđer Bošković Institute



The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) were analyzed in various carcinomas and their potential prognostic significance was determined. The objective of our study was to determine the correlation between these parameters and the survival of patients with small cell lung cancer (SCLC), since very few studies have been published on this type of carcinoma.

Patients and methods

One hundred and forty patients diagnosed with SCLC at our institution between 2012 and 2016 were retrospectively analyzed. Extensive-stage disease (ED) was verified in 80 patients and limited-stage disease (LD) in 60 patients. We analyzed the potential prognostic significance of various laboratory parameters, including NLR, PLR, and LMR, measured before the start of treatment.


Disease extension, response to therapy, chest irradiation and prophylactic cranial irradiation (PCI), as well as hemoglobin, monocyte count, C-reactive protein (CRP), and lactate dehydrogenase (LDH) showed a prognostic significance in all patients. When we analyzed the patients separately, depending on the disease extension, we found that only skin metastases as well as LDH and NLR values, regardless of the cut-off value, had a prognostic significance in ED. Meanwhile, the ECOG performance status, chest irradiation, PCI, and hemoglobin and creatinine values had a prognostic significance in LD.


NLR calculated before the start of the treatment had a prognostic significance for ED, while PLR and LMR had no prognostic significance in any of the analyzed groups of patients.


How to Cite
Drpa, G., Šutić, M., Baranašić, J., Jakopović, M., Samaržija, M., Kukulj, S., & Knežević, J. (2020). Neutrophil-to-lymphocyte ratio can predict outcome in extensive small cell lung cancer. Radiology and Oncology, 54(4), 437-446. Retrieved from
Clinical oncology