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Volume 14
Issue 16
10.3390/jcm14165892
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Article

Prognostic Role of the Naples Score in Extensive-Stage Small Cell Lung Cancer: A Missed Opportunity in Inflammation-Based Stratification

by
Fahri Akgül
1,
İvo Gökmen
2,*,
İsmail Bayrakçı
1,
Didem Divriklioğlu
1,
Aysun Fatma Akkuş
1,
Gizem Bakır Kahveci
1,
Tayyip İlker Aydın
1 and
Bülent Erdoğan
1
1
Division of Internal Medicine, Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne 17000, Turkey
2
Department of Medical Oncology, Mehmet Akif Ersoy State Hospital, Çanakkale 17000, Turkey
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2025, 14(16), 5892; https://doi.org/10.3390/jcm14165892
Submission received: 17 July 2025 / Revised: 12 August 2025 / Accepted: 19 August 2025 / Published: 21 August 2025
(This article belongs to the Section Oncology)
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Abstract

Background: The Naples Prognostic Score (NPS) is a composite inflammation–nutrition index whose prognostic value has been scarcely examined in extensive-stage small cell lung cancer (ES-SCLC). This study aimed to evaluate the prognostic significance of the NPS in this setting. Methods: A retrospective analysis was performed on 142 patients diagnosed with ES-SCLC between March 2014 and June 2024. The NPS was calculated using the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), serum albumin, and total cholesterol levels. Patients were classified into three NPS categories (0, 1–2, and 3–4), and subsequently dichotomized into low-risk (0–2) and high-risk (3–4) groups. Survival outcomes were assessed using Kaplan–Meier estimates and multivariate Cox regression models. Results: Median overall survival (OS) was significantly longer in the low-risk group compared to the high-risk group (10.3 vs. 6.3 months; p = 0.012). High NPS remained an independent predictor of reduced OS (HR: 1.45; 95% CI: 1.02–2.06; p = 0.041). The prognostic strength of the NPS was primarily driven by low LMR and hypoalbuminemia, which were individually associated with worse outcomes. Conclusions: The NPS may serve as a simple, accessible, and independent prognostic tool in ES-SCLC, potentially aiding in clinical risk stratification and treatment planning.
Keywords: Naples Prognostic Score; small cell lung cancer; overall survival; inflammation; prognostic index Naples Prognostic Score; small cell lung cancer; overall survival; inflammation; prognostic index

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MDPI and ACS Style

Akgül, F.; Gökmen, İ.; Bayrakçı, İ.; Divriklioğlu, D.; Akkuş, A.F.; Bakır Kahveci, G.; Aydın, T.İ.; Erdoğan, B. Prognostic Role of the Naples Score in Extensive-Stage Small Cell Lung Cancer: A Missed Opportunity in Inflammation-Based Stratification. J. Clin. Med. 2025, 14, 5892. https://doi.org/10.3390/jcm14165892

AMA Style

Akgül F, Gökmen İ, Bayrakçı İ, Divriklioğlu D, Akkuş AF, Bakır Kahveci G, Aydın Tİ, Erdoğan B. Prognostic Role of the Naples Score in Extensive-Stage Small Cell Lung Cancer: A Missed Opportunity in Inflammation-Based Stratification. Journal of Clinical Medicine. 2025; 14(16):5892. https://doi.org/10.3390/jcm14165892

Chicago/Turabian Style

Akgül, Fahri, İvo Gökmen, İsmail Bayrakçı, Didem Divriklioğlu, Aysun Fatma Akkuş, Gizem Bakır Kahveci, Tayyip İlker Aydın, and Bülent Erdoğan. 2025. "Prognostic Role of the Naples Score in Extensive-Stage Small Cell Lung Cancer: A Missed Opportunity in Inflammation-Based Stratification" Journal of Clinical Medicine 14, no. 16: 5892. https://doi.org/10.3390/jcm14165892

APA Style

Akgül, F., Gökmen, İ., Bayrakçı, İ., Divriklioğlu, D., Akkuş, A. F., Bakır Kahveci, G., Aydın, T. İ., & Erdoğan, B. (2025). Prognostic Role of the Naples Score in Extensive-Stage Small Cell Lung Cancer: A Missed Opportunity in Inflammation-Based Stratification. Journal of Clinical Medicine, 14(16), 5892. https://doi.org/10.3390/jcm14165892

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