Prognostic Value of Inflammatory Markers Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Recurrence and Survival of Chondrosarcoma

Abstract

Introduction:
Chondrosarcoma (CS) is a sarcoma characterized by a high recurrence rate and a variable prognosis. Despite therapeutic advances, there remains a clinical need to identify biomarkers that can predict recurrence and clinical outcomes. Systemic inflammatory markers such as the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) have shown prognostic value in various malignancies; however, their application in bone sarcomas is not standardized.

Objectives:
To determine the association between inflammatory markers NLR and PLR with recurrence and mortality in patients with CS, as well as to correlate the levels of inflammatory markers with the clinical stage of the tumors.

Methodology:
A retrospective cohort study was conducted including patients over 18 years of age with a histopathological diagnosis of appendicular CS, negative surgical margins, and a minimum follow-up of 5 years. Preoperative NLR and PLR values were calculated, cutoff points were determined using ROC curves, and survival was analyzed using Kaplan–Meier curves and Cox regression.

Results:
A total of 44 patients were included. The PLR showed an area under the curve (AUC) of 0.7 with a cutoff point ≥108.3, sensitivity of 77.8%, and specificity of 65.7%. The NLR showed an AUC of 0.41, lacking discriminative value. Patients were stratified according to the PLR cutoff, but no significant differences were found between groups regarding clinical or demographic variables. No significant differences were observed in survival analysis.

Conclusion:
PLR demonstrated a moderate ability to discriminate recurrence in patients with appendicular chondrosarcoma, although it was not statistically significant for predicting survival. NLR showed no prognostic utility in this cohort.