Avaliação sequencial de valores hematológicos como factor prognostico para doentes com Glioblastoma

Abstract

Purpose: Inflammatory cells are important promoters of tumour growth considered as prognostic factors. Glioblastoma (GBM) is no different. Hence, we intended to evaluate the inflammatory parameters, NLR, PLR, RDW-CV and RDW-SD in different phases of GBM treatment protocols, in order to understand whether there will be values that allow us to predict patient's prognosis in terms of progression free survival (PFS) and overall survival (OS). Methods: The population of this study consists of a cohort of 124 patients followed in the Neurosurgery Department of a tertiary care hospital, between January/2014 and December/2018. We performed univariate and multivariate analysis correlating NLR, PLR, RDW-CV, RDW-SV with OS and PFS per treatment time-point. Results: In our univariate analysis, several hematological parameters were related with OS and PFS. For those same parameters, we observed that pre-chemotherapy NLR value <4 had a better OS compared to values >4 (p = 0.0007) and NLR PreS-PosS (difference between pre-surgery and pos-surgery) differ significantly between patients with values < 5 and those with values > 5 (p = 0.0261). Additionally, pre-chemotherapy PLR values >9 and NLR values >4 were associated with a lower PFS (p = 0.0008; p = 0.0003). However, in multivariate analysis we did not show statistically significant values for these same parameters. Conclusions: The results of the present study demonstrated that higher pre-chemotherapy NLR and PLR values were associated with worse prognosis and NLR PreS-PosS values are associated with better prognosis. However, none of these parameters coulb be considered independent prognostic factors for GBM.