(P 313) RELATION BETWEEN NUTRITIONAL/INFLAMMATORY PARAMETERS AND PROGNOSIS IN CHILDHOOD SARCOMA PATIENTS

Objective: In recent years, it has been suggested that there is a relationship between so-called nutritional and inflammatory indicators and prognosis or drug treatment effects in various cancer types. In sarcoma, neutrophil-to-lymphocyte ratio (NLR) levels have been reported to be associated with life prognosis or therapeutic efficacy, but reports in pediatric patients are scarce for any cancer type. In this study, we investigated the survival period, the presence or absence of metastasis, and each nutrient/inflammatory index of pediatric sarcoma patients aged 7~18 years who were treated at our hospital, and examined the relationship between them.

Methods: The subjects were 26 pediatric sarcoma patients between the ages of 7~18 years who were treated at our hospital, and absolute lymphocyte count (ALC), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) at the initial diagnosis as nutrition/inflammatory indicators, lymphocyte-to-monocyte ratio (LMR), C-reactive protein (CRP), modified Glasgow prognostic score (GPS), prognostic nutritional index (PNI) and survival/death at final investigation, presence or absence of distant metastases. The relationship between each parameters and prognosis was investigated.

Results: Osteosarcoma was the most common disease in 16 patients, followed by Ewing's sarcoma and undifferentiated pleomorphic sarcoma in 2 patients, and 6 other diseases in 1 patient each. Among the nutrition/inflammatory indicators, significant differences between survivors and death patients at the time of the final survey were high levels of CRP, NLR, and PLR for all diseases, and high levels of PLR for osteosarcoma. There was no clear association with the presence or absence of metastases.

Conclusion: As with various adult cancer types, in pediatric sarcoma patients, nutrition/inflammation indices at the initial start of treatment could be prognostic markers. Recently, there are several reports indicating that the interaction between platelets and tumor cells could promote tumor progression such as distant metastasis, and sarcomas are not exceptional. Current study showed that high PLR would specifically be an indicator marker of poor prognosis, suggesting that platelets might be a possible tumor promoter.