Prognostic Role of Systemic Inflammatory Markers in Pediatric Soft-Tissue Sarcoma: A Multicenter Study of 213 Patients
Anna Gabrych
Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, Gdansk, Poland
Search for more papers by this authorMalgorzata A. Krawczyk
Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, Gdansk, Poland
Search for more papers by this authorMalgorzata Styczewska
Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, Gdansk, Poland
Search for more papers by this authorWeronika Lyzinska
Department of Pediatrics, Hematology and Oncology, University Clinical Center in Gdansk, Gdansk, Poland
Search for more papers by this authorJadwiga Weclawek-Tompol
Department of Pediatric Hematology/Oncology and BMT, University of Wroclaw, Wroclaw, Poland
Search for more papers by this authorIwona Dachowska-Kalwak
Department of Pediatric Hematology/Oncology and BMT, University of Wroclaw, Wroclaw, Poland
Search for more papers by this authorBernarda Kazanowska
Department of Pediatric Hematology/Oncology and BMT, University of Wroclaw, Wroclaw, Poland
Search for more papers by this authorMalgorzata Sawicka-Zukowska
Department of Pediatric Oncology and Hematology, Medical University of Bialystok, Bialystok, Poland
Search for more papers by this authorMaryna Krawczuk-Rybak
Department of Pediatric Oncology and Hematology, Medical University of Bialystok, Bialystok, Poland
Search for more papers by this authorMonika Richert-Przygonska
Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University, Antoni Jurasz University Hospital, Bydgoszcz, Poland
Search for more papers by this authorJan Styczynski
Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University, Antoni Jurasz University Hospital, Bydgoszcz, Poland
Search for more papers by this authorJulia Geisler-Paliwoda
Department of Pediatric Hematology and Oncology, Medical University of Silesia, Katowice, Poland
Search for more papers by this authorTomasz Szczepanski
Department of Pediatric Hematology and Oncology, Medical University of Silesia, Katowice, Poland
Search for more papers by this authorWioletta Bal
Department of Pediatric Oncohematology, Clinical Province Hospital of Rzeszow, Rzeszow, Poland
Search for more papers by this authorRadoslaw Chaber
Department of Pediatric Oncohematology, Clinical Province Hospital of Rzeszow, Rzeszow, Poland
Department of Pediatrics, Institute of Medical Sciences, Medical College, University of Rzeszow, Rzeszów, Poland
Search for more papers by this authorMichal Kunc
Department of Pathomorphology, Medical University of Gdansk, Gdansk, Poland
Search for more papers by this authorCorresponding Author
Ewa Bien
Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, Gdansk, Poland
Search for more papers by this authorAnna Gabrych
Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, Gdansk, Poland
Search for more papers by this authorMalgorzata A. Krawczyk
Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, Gdansk, Poland
Search for more papers by this authorMalgorzata Styczewska
Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, Gdansk, Poland
Search for more papers by this authorWeronika Lyzinska
Department of Pediatrics, Hematology and Oncology, University Clinical Center in Gdansk, Gdansk, Poland
Search for more papers by this authorJadwiga Weclawek-Tompol
Department of Pediatric Hematology/Oncology and BMT, University of Wroclaw, Wroclaw, Poland
Search for more papers by this authorIwona Dachowska-Kalwak
Department of Pediatric Hematology/Oncology and BMT, University of Wroclaw, Wroclaw, Poland
Search for more papers by this authorBernarda Kazanowska
Department of Pediatric Hematology/Oncology and BMT, University of Wroclaw, Wroclaw, Poland
Search for more papers by this authorMalgorzata Sawicka-Zukowska
Department of Pediatric Oncology and Hematology, Medical University of Bialystok, Bialystok, Poland
Search for more papers by this authorMaryna Krawczuk-Rybak
Department of Pediatric Oncology and Hematology, Medical University of Bialystok, Bialystok, Poland
Search for more papers by this authorMonika Richert-Przygonska
Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University, Antoni Jurasz University Hospital, Bydgoszcz, Poland
Search for more papers by this authorJan Styczynski
Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University, Antoni Jurasz University Hospital, Bydgoszcz, Poland
Search for more papers by this authorJulia Geisler-Paliwoda
Department of Pediatric Hematology and Oncology, Medical University of Silesia, Katowice, Poland
Search for more papers by this authorTomasz Szczepanski
Department of Pediatric Hematology and Oncology, Medical University of Silesia, Katowice, Poland
Search for more papers by this authorWioletta Bal
Department of Pediatric Oncohematology, Clinical Province Hospital of Rzeszow, Rzeszow, Poland
Search for more papers by this authorRadoslaw Chaber
Department of Pediatric Oncohematology, Clinical Province Hospital of Rzeszow, Rzeszow, Poland
Department of Pediatrics, Institute of Medical Sciences, Medical College, University of Rzeszow, Rzeszów, Poland
Search for more papers by this authorMichal Kunc
Department of Pathomorphology, Medical University of Gdansk, Gdansk, Poland
Search for more papers by this authorCorresponding Author
Ewa Bien
Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, Gdansk, Poland
Search for more papers by this authorAnna Gabrych, Malgorzata A. Krawczyk, Michal Kunc, and Ewa Bien contributed equally to this study.
This study has been presented as a poster presentation entitled “Znaczenie prognostyczne markerów systemowego zapalenia w mięsakach tkanek miękkich u dzieci: wyniki wieloośrodkowego badania 213 pacjentów” during the 12th Meeting of the Polish Society of Pediatric Oncology and Hematology in Cracow (08-08.06.2024).
ABSTRACT
Background
The prognostic role of systemic inflammation markers in pediatric soft-tissue sarcomas (STS) remains unclear.
Procedure
This multicenter study investigated the prognostic significance of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), C-reactive protein (CRP), and lactate dehydrogenase (LDH) in 213 pediatric patients diagnosed with STS in years 2002–2023. Patients were categorized into groups: rhabdomyosarcoma (RMS, n = 126), RMS-like (n = 57), and non-RMS (n = 30). Clinicopathological data, including complete blood counts (CBCs), CRP, and LDH levels, were collected and age-adjusted. Optimal cutoffs for predicting outcomes were determined, and the prognostic value of the inflammatory markers was assessed using Kaplan–Meier survival analysis, log-rank tests, and Cox regression models.
Results
No significant differences in NLR, PLR, LMR, and CRP levels were observed between RMS, RMS-like, and non-RMS groups. However, LDH levels were significantly elevated in the RMS group compared with the RMS-like group. A consistent trend toward higher NLR, PLR, and CRP values was noted in patients with more advanced disease stages. Multivariate Cox regression analysis across the entire cohort identified CRP (HR 3.39, 95% CI 1.55–7.4, p = 0.002), NLR (HR 2.06, 95% CI 1.07–3.99, p = 0.03), and disease stage (HR = 0.49, 95% CI 0.26–0.95, p = 0.035) as independent prognostic factors for survival. Subgroup analyses revealed that the prognostic impact of these markers varied across histopathological subtypes, with limited utility in the RMS-like group.
Conclusions
These findings highlight the prognostic value of systemic inflammatory markers in pediatric STS, emphasizing their potential to refine risk assessment and guide treatment.
Conflicts of Interest
The authors report no conflict of interest.
Open Research
Data Availability Statement
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
Supporting Information
| Filename | Description |
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| pbc31701-sup-0001-TableS1-S2.docx20.6 KB | Supporting Information |
| pbc31701-sup-0002-FigureS1.tif10.4 MB | Supporting Information |
| pbc31701-sup-0003-FigureS2.tif10.4 MB | Supporting Information |
| pbc31701-sup-0004-FigureS3.tif10.4 MB | Supporting Information |
| pbc31701-sup-0005-FigureS4.tif10.4 MB | Supporting Information |
| pbc31701-sup-0006-FigureS5.tif10.4 MB | Supporting Information |
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