Schoenfeld AJ, et al. - Researchers examined the prognostic value of laboratory indices at presentation including white blood cell (WBC) count, serum albumin and platelet-lymphocyte ratio (PLR) for patients with spinal metastases. They retrospectively reviewed the records of 1,216 patients, aged 40-80, who received operative or non-operative management for spinal metastases at two tertiary care centers (2005-2017). Surgical intervention was undertaken in 37 % of patients and non-operative management was done in 63%. The cohort as a whole had median survival of 255 days. Observations revealed a significant association of PLR and albumin with survival, while no association of WBC count with this outcome. Hence they recommend advising individuals with low serum albumin and elevated PLR concerning the influence of these laboratory markers on outcomes including survival, irrespective of treatments received. If practicable, optimization of nutrition and PLR, prior to treatment, is recommended to reduce the potential for development of adverse events.