Prognostic Analysis of NLR, PLR, and, LMR in Osteosarcoma at Dr. Wahidin Sudirohusodo Hospital

Abstract

Osteosarcoma is a primary pediatric bone malignancy with an annual incidence of 5.6 cases per million children under the age of 15. The high mortality rate leads to necessary for prognostic biomarkers of the disease. NLR, PLR, and LMR can be considered as prognostic predictors of osteosarcoma patients. This study aimed to determine the difference and correlation between NLR, PLR, and LMR based on grade and outcome in osteosarcoma patients. The study used medical record data from 122 osteosarcoma patients at Dr. Wahidin Sudirohusodo Hospital, Makassar. Samples were grouped by stage according to Enneking criteria (Grade I, II, and III) and by outcome (deceased and not deceased), then analyzed based on NLR, PLR, and LMR values using the Kruskal-Wallis test and the Mann-Whitney test (significant if p<0.05). There was a significant difference in NLR, PLR, and LMR values by grade, (p=0.05). There was a significant difference in the value of NLR, and LMR based on output (p=0.00), but not in PLR (p=0.954). There was a correlation between the values of NLR, PLR, and LMR and the stage of osteosarcoma (p=0.05). Based on the outcome, a correlation with the NLR and LMR values was obtained (p=0.00), but there was no correlation with the PLR value (p=0.955). Cut-off NLR, PLR, and LMR were 4.43; 0.21; and 0.44, respectively, with sensitivity of 76%, 56%, and 76% and a specificity of 76%, 63.9%, and 68%, respectively. There were differences in NLR, PLR, and LMR values based on the stage and outcome of osteosarcoma.  Higher NLR, PLR, and LMR values will lead to a higher stage of osteosarcoma and a worse outcome. Cut-off NLR, PLR, and LMR optimal for distinguishing stage of osteosarcoma were 4.43; 0.21, and 0.44, respectively.