Comparison of prognostic value of neutrophil-to-lymphocyte ratio (NLR) in patients with metastatic and non-metastatic cancers

Background Several studies have reported NLR as an independent prognostic factor in solid tumors. However, comparing the prognostic value among metastatic and non-metastatic cancers remains underexplored, which is the objective of this study. Methods A total of 182 patients with different types of metastatic and non-metastatic cancers were enrolled in this retrospective study. Of these patients, chemotherapy was the main treatment received (56.6%). We compared the prognostic value among metastatic and non-metastatic cancers. Overall survival (OS) was used as an outcome metric. Univariate and multivariate Cox proportional hazards analyses were used to investigate the association between NLR and OS. Results In this study, metastatic cancer patients with high NLR demonstrated the worst survival outcomes in Kaplan-Meier survival analysis, whereas non-metastatic cancer patients showed minimal survival decline. Conversely, metastatic and non-metastatic cancer patients with low NLR maintained the highest survival probability. Multivariate analysis further identified high NLR as an independent predictor of poor overall survival. NLR showed a maximum sensitivity (S1) of 1 and specificity (S2) of 0.75, with an optimal cut-off value of NLR = 2.75 using receiver operating characteristic (ROC) curve analysis. The area under the curve (AUC) was slightly increased in patients with metastatic cancers (0.717), compared to those with non-metastatic cancers (0.715), indicating that NLR serves as a more effective predictor of survival in metastatic cancers. Conclusions In conclusion, the study findings indicate a significant association between high NLR and worse overall survival in metastatic cancers compared with minimal survival decline in non-metastatic cancers. NLR is still rolling in research articles, seeking gaps to reach routine clinical practice. Trial registration: Not applicable.