Clinical Research Papers:
Neutrophil count and percentage: potential independent prognostic indicators for advanced cancer patients in a palliative care setting
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Weiwei Zhao1,2,*, Peng Wang2,3,*, Huixun Jia2,4, Menglei Chen1, Xiaoli Gu1, Minghui Liu1, Zhe Zhang1, Wenwu Cheng1,2 and Zhenyu Wu5
1 Center for Biomedical Statistics, Fudan University Shanghai Cancer Center, Shanghai, China
2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
3 Department of Integrative Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
4 Center for Biomedical Statistical, Fudan University Shanghai Cancer Center, Shanghai, China
5 Department of Biostatistics, School of Public Health, Key Laboratory of Public Health Safety and Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
* These authors have contributed equally to this work
Zhenyu Wu, email:
Wenwu Cheng, email:
Keywords: neutrophil count, neutrophil percentage, prognostic value, advanced cancer, palliative care
Received: November 15, 2016 Accepted: March 09, 2017 Published: March 22, 2017
The purpose of this study was to evaluate the count and percentage of neutrophils as prognostic indicators in advanced cancer patients undergoing palliative care. 378 consecutive patients receiving treatment at the palliative care unit of Fudan University Shanghai Cancer Center between July 2013 and October 2015 were reviewed. In 106 of these patients, the data were extended during the follow-up. The cut-off values selected for the neutrophil count and percentage were 8.0×109/L and 85%, respectively. Both a high pretreatment neutrophil count (HR = 1.828, 95% CI: 1.409~2.371, P<0.001) and a high pretreatment neutrophil percentage (HR = 1.475, 95% CI: 1.106~1.967, P=0.008) were independent prognostic factors for decreased overall survival. Furthermore, in the follow-up cohort of readmitted patients (n = 106), patients with a newly increased neutrophil count or percentage were respectively, 1.837 (95% CI: 1.096~3.079) and 3.268 (95% CI: 1.848~5.778) times more likely to have a poor prognosis compared with patients with low neutrophil conditions (P=0.021, P<0.001). In conclusions, both high pretreatment or newly increased count and percentage of neutrophils were confirmed as independent prognostic factors for adverse outcomes. These parameters may be used as stratification factors in identifying advanced cancer patients with poor prognosis in palliative care settings.
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