Objective To investigate the relationship between neutrophils to lymphocytes ratio (NLR) and the prognosis of retroperitoneal liposarcoma patients and other prognostic factors.

Methods We collected 109 patients diagnosed asretroperitoneal liposarcoma. All patients were divided into two groups according to the preoperative NLR: high NLR group (NLR > 2.78) and low NLR group (NLR≤2.78). The survival rates were compared between the two groups. In addition, other clinicopathological features and prognostic factors of retroperitoneal liposarcoma patients were analyzed, including the patient's medical history, tumor features and operation characters.

Results The 5-year survival rates in the high NLR group and low NLR group were 50% and 84.6%, respectively (P=0.016). Patients with high NLR had a higher malignancy (P=0.033), and the NLR level was associated with immunity, inflammatory response and liver function of patients (P=0.001, P=0.000). Besides, there were significant differences between the two groups of dedifferentiated and highly-differentiated retroperitoneal lipomas (P=0.004). The patients with history of smoking and drinking always had poorer outcomes (P=0.032, P=0.004). Male and female patients with 5-year survival were 45.5% and 84.6%, respectively (P=0.006). In addition, the results of surgical excision showed that 5-year survival rates of the patients with piecemeal resection, palliative resection and complete resection were 66.7%, 90% and 20%, respectively (P=0.027).

Conclusion NLR could be used as a prognostic indicator of retroperitoneal lipoma. Preoperative NLR > 2.78 indicates poor prognosis. Patients with history of smoking and drinking have a poor prognosis for retroperitoneal liposarcoma. The 5-year survival rate of patients with palliative resection is higher than those with piecemeal resection and complete resection.