Neutrophil-to-lymphocyte Ratio as a PrognosticBiomarker in Peruvian Patients with AcralMelanoma

Abstract

Objective. Our aim was to evaluate whether NLR, LMR, and PLR serve as prognostic biomarkers in AM, the most frequent subtype of cutaneous melanoma (CM) in Peru. Materials and methods. A retrospective study was conducted, including patients diagnosed with AM between 2010 and 2015. Survival analysis was performed using Kaplan-Meier curves and comparisons were made using the log-rank test. Univariate and multivariate survival models were constructed using
Cox regression analysis. A p-value less than 0.05 was considered significant. Results. Among our cohort of 135 patients with CM, 51.1% (69 cases) had AM. The median age was 68 years, with a predominance of females (55%), and 88.4% had the plantar site as the primary site. The 5-year overall survival (OS) rate was 54.3%. In the univariate analysis, Clark level III/IV, anaplasia, lymphocytic invasion, stage III-IV, and NLR were associated with poor prognosis. In multivariate
analysis, NLR >3.5 (HR 3.9, 95% CI 1.5-10.3, p=0.005) and Clark level III-IV (HR 3.5, 95% CI 1.6- 7.8, p=0.002) were associated with poor OS. Conclusion. NLR emerges as an independent prognostic factor for OS among Peruvian patients with AM in a single cancer center institution.