Open Access
CC BY 4.0 · Rev Bras Ortop (Sao Paulo) 2025; 60(01): s00451804497
DOI: 10.1055/s-0045-1804497
Artigo Original

Correlation of the Neutrophil-to-lymphocyte and Platelet-to-lymphocyte Ratios with Postoperative Complications and Survival in Surgery for Bone Metastasis of the Appendicular Skeleton

Article in several languages: português | English
1   Serviço de Oncologia Ortopédica, Hospital Erasto Gaertner, Curitiba, PR, Brasil
2   Faculdade Evangélica Mackenzie do Paraná, Curitiba, PR, Brasil
,
1   Serviço de Oncologia Ortopédica, Hospital Erasto Gaertner, Curitiba, PR, Brasil
2   Faculdade Evangélica Mackenzie do Paraná, Curitiba, PR, Brasil
,
1   Serviço de Oncologia Ortopédica, Hospital Erasto Gaertner, Curitiba, PR, Brasil
2   Faculdade Evangélica Mackenzie do Paraná, Curitiba, PR, Brasil
,
2   Faculdade Evangélica Mackenzie do Paraná, Curitiba, PR, Brasil
,
2   Faculdade Evangélica Mackenzie do Paraná, Curitiba, PR, Brasil
,
2   Faculdade Evangélica Mackenzie do Paraná, Curitiba, PR, Brasil
› Author Affiliations
Preview

Abstract

Objective To analyze, in cases of long-bone metastases, the incidence of postoperative complications and survival of up to 1 year, correlating them with the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR).

Methods Review of 160 medical records of patients who underwent surgery for bone metastases in the appendicular skeleton. We determined epidemiological characteristics and NLR and PLR values, which were correlated with survival and complications.

Results Women represented 64.5% of the sample, and 62.6% presented primary breast tumor. The proximal femur was the most affected bone. The median survival was of 13.2 months, and the 1-year survival rate, of 34.7%. Tumor resection with endoprosthesis was the most common surgery. The postoperative complication rate was of 10%, and the mean time until occurrence was of 27.9 (range: 0–140) days. We observed a significant association between neutrophil levels and postoperative complications (p = 0.04): for every increase of 100 neutrophils, the risk of postoperative complications increased by 1%. The mean NLR and PLR values were of 5.3 (range: 0.2–30.7) and 199.7 (range: 32.1–676.7) respectively. Patients with NLR ≥ 2 (p < 0,001) showed a decrease in survival from 92,3 to 62,5% in the third month, and from 61,5 to 31,3% in the first year. Those with PLR ≥ 209 (p < 0.001) showed a decrease in survival from 69 to 59.3% in the third month, and from 40.2 to 25.9% in the first year.

Conclusion There was no positive association regarding the NLR and PLR and postoperative complications. However, we noted a strong correlation involving elevated NLR and PLR levels and reduced life expectancy starting from the third postoperative month.

Authors' Contributions

Each author contributed individually and significantly to the development of the present article: MST and AVRT: conceptualization and investigation; CAPMR: methodology; FIT: project administration; and all authors: writing – review and editing.


Financial Support

The authors declare that they did not receive financial support from agencies in the public, private, or non-profit sectors to conduct the present study.


* Study developed at Hospital Erasto Gaertner in partnership with Faculdade Evangélica Mackenzie do Paraná, Curitiba, PR, Brazil.




Publication History

Received: 11 September 2024

Accepted: 14 December 2024

Article published online:
11 April 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

Thieme Revinter Publicações Ltda.
Rua Rego Freitas, 175, loja 1, República, São Paulo, SP, CEP 01220-010, Brazil

Bibliographical Record
Matheus Silva Teixeira, Ana Valeria Rigolino Teixeira, Glauco Jose Pauka Mello, Fernando Issamu Tabushi, Claudio Luciano Franck, Carmen Austrália Paredes Marcondes Ribas. Correlação das razões neutrófilo-linfócito e plaqueta-linfócito com complicações e sobrevida pós-operatórias na cirurgia para metástase óssea do esqueleto apendicular. Rev Bras Ortop (Sao Paulo) 2025; 60: s00451804497.
DOI: 10.1055/s-0045-1804497