The prognostic role of the neutrophil-to-lymphocyte ratio in the clinical outcomes of patients with iodine-refractory differentiated thyroid cancer treated with sorafenib
CHEN Jie
DONG Peng
WANG Zhijie
Abstract：Objective To investigate the prognostic value of neutrophil-to-lymphocyte ratio(NLR)in patients with radioactive iodine-refractory differentiated thyroid cancer(RAIR-DTC)treated with sorafenib.Methods Clinical and pathological data of 84 RAIR-DTC patients admitted to Zhangjiakou First Hospital from September 2018 to September 2023 were included.All patients received sorafenib treatment with an initial dose of 800 mg/d.Blood routine indicators were collected before sorafenib treatment,and the NLR was calculated.Patients were divided into high and low groups based on the median NLR value of 2.2.Cox proportional hazards regression model was used to analyze independent prognostic factors affecting progression-free survival(PFS)and overall survival(OS)duration.Results There was no statistically significant difference between the low-NLR group and the high-NLR group in terms of age,gender,pathological type,primary tumor diameter,and tumor metastasis site(P>0.05).The median PFS in the low-NLR group was 11.5 months,significantly longer than 6.6 months in the high-NLR group(P<0.05).Multivariate analysis revealed that pretreatment NLR served as an independent factor for PFS(HR=5.579,95%CI:2.834-10.984,P<0.001).The median OS in the low-NLR group reached 59.5 months,markedly longer than 19.8 months in the high-NLR group(P<0.05).Multivariate analysis revealed that brain metastasis(HR=3.520,95%CI:1.137-10.891,P=0.029)and NLR(HR=105.297,95%CI:24.552-451.592,P<0.001)were identified as independent factors for OS.Conclusion NLR serves as a prognostic biomarker for RAIR-DTC patients receiving sorafenib treatment and may guide clinical decision-making.
Keywords：Radioactive iodine-refractory differentiated thyroid cancerNeutrophil-to-lymphocyte ratioSorafenibPrognostic analysis
Publication Date：2025-05-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 457-462 )