Objective: Predicting the life expectancy in patients with terminal cancer is important in terms of clinical assessment and treatment approaches. Although, various prognostic scoring systems have been established and still often used, those are based on subjective parameters. There is a recently increased tendency to anticipate prognosis by prognostic laboratory tests that consist of objective parameters and are easily applied. The role of inflammation in cancer development and progress is a well-known topic. Neutrophil/lymphocyte ratio (NLR) is a objective parameter that could show the level of systemic inflammation. Increasing NLR has been associated with worse prognosis in many type of cancer. In this study, we evaluated the prognostic role of NLR in terminal cancer patients.

Methodology: Patients of 432 who were enrolled as a terminal cancer in Department of Medical Oncology were included in this study. The information of those patients were obtained retrospectively from medical archive records. Hemogram and biochemistry results which were examined on the first day of patients’ last hospitalisation were used. Statistical analyses were done by Independent Sample T or Mann Whitney U test. Two main subgroup were defined; patients who died in first 30 days from last hospitalization or patients who died after 30 days from last hospitalization.

Results: Descriptive data and statistical analysis results are shown in Table 1. The median age of patients was 62. 268 (b) of patients were male and 164 (8) were female. The most frequent cancer type were lung (1), colorectal (%9), and esophagus/stomach (%8), respectively. While the median NLR was 11.36 (min–max, 0.11–367.67), the median thrombocyte/lymphocyte ratio (PLR) was 305.39 (min–max, 3.23–4150). 381 (88%) of the patients were in the group that died within 30 days after the last hospitalization. The median NLR was significantly higher in patients who died within 30 days compared with patients who died after 30 days (11.84 vs. 7.5, p<0.001, respectively) as shown in Table 1. On the other hand, there were no differences between 2 group in terms of other parameters including hemoglobin, leukocyte count, lactate dehydrogenase (LDH), mean platelet volume (MPV), PLR, CRP/albumin ratio, monocyte count, and prognostic nutritional index (PNI) (Table 1).

Conclusion: There is a strong relationship between inflammation and cancer. NLR is a marker to show inflammation. In this study, we showed that increased NLR was associated with worse prognosis in patients with terminal cancer. There are few studies evaluating the prognostic role of NLR in terminal cancer patients in the literature, and our study results are compatible with those. The limitation of our study is to be a retrospective design and single-center study. Further prospective multi-center trials are needed to clarify the prognostic role of NLR. In conclusion, we think that NLR can be used safely for anticipating prognosis in terminal cancer patients due to its easy usage and objectivity.