Significance of the neutrophil-tolymphocyte ratio in predicting the response to neoadjuvant chemotherapy in extremity osteosarcoma: A multicentre retrospective study

At present, no predictive factor has been validated for the early efficacy of neoadjuvant chemotherapy (NACT) in osteosarcoma. The purpose of this study was to investigate the significance of the neutrophil-to-lymphocyte ratio (NLR) in predicting the response to NACT in extremity osteosarcoma. | Tang et al. BMC Cancer 2022 22 33 https s12885-021-09130-7 RESEARCH Open Access Significance of the neutrophil-to- lymphocyte ratio in predicting the response to neoadjuvant chemotherapy in extremity osteosarcoma a multicentre retrospective study Haijun Tang1 Dehuai Liu1 Jili Lu2 Juliang He3 Shuyu Ji4 Shijie Liao5 Qingjun Wei5 Shenglin Lu1 and Yun Liu6 Abstract Background At present no predictive factor has been validated for the early efficacy of neoadjuvant chemotherapy NACT in osteosarcoma. The purpose of this study was to investigate the significance of the neutrophil-to-lympho- cyte ratio NLR in predicting the response to NACT in extremity osteosarcoma. Methods Pathological complete response pCR was used to assess the efficacy of NACT. Receiver operating char- acteristic ROC curves and the Youden index sensitivity specificity-1 were used to determine the optimal cut-off values of the NLR. Univariate and multivariate analyses using logistic regression models were conducted to confirm the independent factors affecting the efficacy of NACT. Results The optimal NLR cut-off value was sensitivity specificity . Univariate analysis revealed that patients with a smaller tumour volume lower stage lower NLR and lower PLR were more likely to achieve pCR. Multivariate analyses confirmed that the NLR before treatment was an independent risk factor for pCR. Compared to patients with a high NLR those with a low NLR showed a more than 2-fold higher likelihood of achieving pCR OR 95 CI p . Conclusion The NLR is a novel and effective predictive factor for the response to NACT in extremity osteosarcoma patients. Patients with a higher NLR showed a lower percentage of pCR after NACT. Keywords Neutrophil-to-lymphocyte Neoadjuvant chemotherapy Osteosarcoma Introduction and adolescents 1 . Before the 1970s the main treatment Osteosarcoma which originates from mesenchymal tis- method for this disease was amputation and postopera- sue

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