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Inflammation‑scores as prognostic markers of overall survival in lung cancer: A register‑based study of 6,210 Danish lung cancer patients

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Information-scores based on general inflammation markers are suggested as prognostic markers of overall survival (OS) in lung cancer. However, whether these inflammation-scores improves the prognostication per‑ formed by well-established prognostic markers is unsettled. In a large register-based lung cancer patient cohort, nine diferent inflammation-scores were compared, and their ability to optimize the prognostication of OS was evaluated. | Winther Larsen et al. BMC Cancer 2022 22 63 https doi.org 10.1186 s12885-021-09108-5 RESEARCH Open Access Inflammation scores as prognostic markers of overall survival in lung cancer a register based study of 6 210 Danish lung cancer patients Anne Winther Larsen1 Ninna Aggerholm Pedersen2 and Birgitte Sandfeld Paulsen1 3 Abstract Background Inflammation-scores based on general inflammation markers are suggested as prognostic markers of overall survival OS in lung cancer. However whether these inflammation-scores improves the prognostication per formed by well-established prognostic markers is unsettled. In a large register-based lung cancer patient cohort nine different inflammation-scores were compared and their ability to optimize the prognostication of OS was evaluated. Methods Lung cancer patients diagnosed from 2009 2018 in The Central Denmark Region were identified in the Danish Lung Cancer Registry. Pre-treatment inflammation markers were extracted from the clinical laboratory information system. Prognostication of OS was evaluated by Cox proportional hazard models. Comparison of the inflammation-scores and their added value to established prognostic markers were assessed by Akaike s information criteria and Harrel s C-index. Results In total 5 320 patients with non-small cell lung cancer NSCLC and 890 patients with small cell lung cancer SCLC were identified. In NSCLC the Aarhus composite biomarker score ACBS including albumin C-reactive protein neutrophil count lymphocyte count and haemoglobin and the neutrophil-lymphocyte-ratio NLR were superior. Furthermore they improved the prognostication of OS significantly p Winther Larsen et al. BMC Cancer 2022 22 63 Page 2 of 10 proven clinically relevant. The tumor node and metasta- included if they were diagnosed with lung cancer reg- sis TNM staging system which classifies patients into istered in The Central Denmark Region and the Danish clinical and pathological stages 3 and the Eastern coop- Lung Cancer .