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High neutrophil\u2010to\u2010lymphocyte ratio (NLR) and platelet\u2010to\u2010lymphocyte ratio (PLR) as markers of host inflammation have been found to be associated with decreased long\u2010term outcomes in several tumour types, but have been scarcely analysed in ACC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients who underwent resection of their ACC between 2000 and 2020 were identified; therapeutic, operative and outcome data were analysed. Pre\u2010operative NLR and PLR were calculated by division of neutrophils and platelets by lymphocytes measured in peripheral blood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010seven patients (30F:27\u00a0M) with an overall median age of 53 years [range: 18\u201386] presented with tumours of median size 11.5\u00a0cm [range: 3.0\u201322.0], of whom 26 (46%) were hormonally active. Majority of patients underwent an open resection (<jats:italic>n<\/jats:italic>\u2009=\u200948; 84%); more than half (<jats:italic>n<\/jats:italic>\u2009=\u200930; 53%) underwent multi\u2010organ excision. Median NLR was 4.63 and median PLR was 186.21; these values were used for median split analyses (low vs. high). There were no differences with regard to age, sex or tumour characteristics and peri\u2010operative data between the two groups (all<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). Overall, median recurrence\u2010free survival (RFS) was 26\u00a0months (3\u2010year: 45%) on Kaplan\u2013Meier analysis. On univariate analyses, a high NLR did not influence RFS [HR\u2009=\u20091.57 (95%\u2010CI: 0.73\u20132.38);<jats:italic>p<\/jats:italic>\u2009=\u20090.25], but patients with a high PLR had an increased risk of developing recurrence [HR\u2009=\u20092.39 (95%\u2010CI: 1.08\u20135.31);<jats:italic>p<\/jats:italic>\u2009=\u20090.03]. The median overall survival (OS) was 33\u00a0months (3 years: 79%) on Kaplan\u2013Meier analysis. Both a high NLR [HR\u2009=\u20092.24 (95%\u2010CI: 1.07\u20134.70);<jats:italic>p<\/jats:italic>\u2009=\u20090.03] and a high PLR [HR\u2009=\u20094.02 (95%\u2010CI: 1.80\u20138.98);<jats:italic>p<\/jats:italic>\u2009=\u20090.001] were strongly associated with a shorter OS on unadjusted analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Elevated pre\u2010operative NLR and PLR are associated with shorter OS, while higher PLR was also associated with a shorter RFS for patients undergoing curative intent resection of ACC.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-020-05868-6","type":"journal-article","created":{"date-parts":[[2020,11,21]],"date-time":"2020-11-21T21:02:26Z","timestamp":1605992546000},"page":"754-764","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Neutrophil\u2010to\u2010Lymphocyte Ratio (NLR) and Platelet\u2010to\u2010Lymphocyte Ratio (PLR) as Possible Prognostic Markers for Patients Undergoing Resection of Adrenocortical Carcinoma"],"prefix":"10.1002","volume":"45","author":[{"given":"Mechteld C.","family":"de Jong","sequence":"first","affiliation":[{"name":"Department of Endocrine Surgery, Churchill Cancer Centre Oxford University Hospitals NHS Foundation Trust OX3 7LE Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radu","family":"Mihai","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery, Churchill Cancer Centre Oxford University Hospitals NHS Foundation Trust OX3 7LE Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahab","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery, Churchill Cancer Centre Oxford University Hospitals NHS Foundation Trust OX3 7LE Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,11,21]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2008.10.008"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2010.235"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-13-0519"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2020.101415"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2005-2730"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2013.11.006"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdv329"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.24030"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-198903000-00004"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-3182"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-013-0049-2"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.2774"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2019.1558"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-019-0221-7"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7819-12-58"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-14-0146"},{"issue":"4","key":"e_1_2_5_18_1","first-page":"294","article-title":"Preoperative neutrophil\u2010to\u2010lymphocyte ratio as a prognostic predictor after radical resection of esophageal squamous cell carcinoma","volume":"36","author":"Chen H","year":"2014","journal-title":"Zhonghua Zhong Liu Za Zhi"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-008-0554-3"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2013.332"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-015-4869-5"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(14)70263-3"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.23982"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12894-017-0240-4"},{"key":"e_1_2_5_25_1","unstructured":"AJCC cancer staging manual eighth edition staging. 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