Potenciais biomarcadores para o prognóstico do câncer avançado e suas associações com a sobrevida global

Abstract

Introduction: Prognosis assessment in patients with advanced cancer is essential for choosing the most appropriate treatment, especially when based on accessible and low-cost biomarkers. Objectives: To investigate the association of potential prognostic biomarkers, RDW (red blood cell distribution width), RPR (ratio of red cell distribution width (RDW) to platelet count), N/L (neutrophil/lymphocyte ratio) and L/M (lymphocyte/monocyte ratio), with overall survival and prognosis of patients with advanced cancer. Material and methods: Eighty-seven patients with advanced solid tumors were evaluated between 2021 and 2022, who were being followed up at the palliative care outpatient clinic, monitored until the cutoff date (11/24/2022). The evaluations included recording general demographic data and clinicopathological characteristics, in addition to analyzing the functional status of patients using the Eastern Cooperative Oncology Group Performance Status (ECOG-PS), and the collection of a venous blood sample. Overall survival (OS) was calculated and survival curves were plotted using the Kaplan-Meier method. The chi-square test was used to compare categorical variables. Results: At the time of data censoring, 43 patients (49.4%) were alive, while 44 (51%) had died. Median overall survival was 246 days or 8.08 months (IQR 0.36-18.9). The majority of patients, 53 (61%), had an ECOG-PS score >0/1 and a total of 79 patients (91%) had metastases. Univariate analysis revealed that patients with elevated RDW >14.95 (HR: 3.411 [1.431-8.130], P = 0.006) and elevated N/L (HR 1.965 [1.031-3.747], P = 0.040) were associated with a higher risk of death and, consequently, shorter overall survival. Furthermore, patients with low L/M levels (HR: 2.032 [1.075-3.840], P = 0.029) exhibited lower overall survival rates. Conclusion: The RDW, N/L, and L/M biomarkers are accurate and cost-effective parameters for predicting overall survival and prognosis of patients with advanced cancer.