General Thoracic and Cardiovascular Surgery

, Volume 65, Issue 11, pp 633–639 | Cite as

Prognostic significance of neutrophil–lymphocyte ratios in large cell neuroendocrine carcinoma

  • Masayuki Okui
  • Takashi Yamamichi
  • Ayaka Asakawa
  • Masahiko Harada
  • Makoto Saito
  • Hirotoshi Horio
Original Article



Large cell neuroendocrine carcinomas (LCNECs) are rare neuroendocrine pulmonary malignancies with poor survival. Towards the goal of identifying a useful prognostic marker for LCNEC, we examined the prognostic significance of the neutrophil–lymphocyte ratio (NLR) in LCNEC patients after complete resection. The NLR is a potential predictive indicator in other cancers and can be easily determined at low cost.


We retrospectively reviewed the perioperative clinical and laboratory data of patients who underwent complete resection for LCNEC between 1995 and 2014. Correlations between the preoperative NLR and clinicopathological parameters were determined to assess its prognostic significance.


Our study consisted of 26 patients, most of whom were men (88.5%) with a median age of 68.8 years. The median follow-up time was 54.4 months. Univariate analysis identified 3 clinically significant overall survival predictors: serum albumin level [≥4.0 g/dL (5-year overall survival rate; 80.0%) vs. <4.0 g/dL (30.0%), p = 0.048], pathological T stage [T1 and T2 (79.6%) vs. T3 and T4 (0%), p = 0.001], and preoperative NLR [<1.7 (90.9%) vs. ≥1.7 (51.7%), p = 0.012]. In a multivariate analysis, the NLR was an independent prognostic factor for overall survival (hazard ratio 8.559, 95% confidence interval 1.783–80.230, p = 0.011).


The preoperative NLR inversely correlates with post-resection survival rates in patients with LCNEC and thus is a viable prognostic marker in LCNEC.


Neutrophil–lymphocyte ratio Large cell neuroendocrine carcinoma Lung cancer Inflammatory cells 


Compliance with ethical standards

Conflict of interest

The authors state that they have no conflicts of interest.

Supplementary material

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Copyright information

© The Japanese Association for Thoracic Surgery 2017

Authors and Affiliations

  1. 1.Department of Thoracic SurgeryTokyo Metropolitan Cancer and Infectious Diseases Center Komagome HospitalTokyoJapan
  2. 2.Division of Clinical Research SupportTokyo Metropolitan Cancer and Infectious Diseases Center Komagome HospitalTokyoJapan

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