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Prognostic value of preoperative neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in patients with epithelial ovarian cancer
1Clinics of Medical Oncology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey
2Institute of Oncology, Dokuz Eylül University, Izmir, Turkey
*Corresponding Author(s): Y. Yildiz E-mail: dryasar2706@yahoo.co.uk
Purpose: The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have recently been evaluated in many cancers in prediction of survival outcomes. The purpose of this study was to investigate the impact of NLR and PLR on the prognosis of patients with epithelial ovarian cancer (EOC). Materials and Methods: A total of 208 patients with EOC were included in the study. Hematological parameters and clinicopathological data during diagnosis were retrospectively evaluated. The cut-off values were determined by calculating receiver operating characteristic (ROC) curve analysis of the patients. Results: The median overall survival (OS) of patients with low NLR was 69 months (95% CI, 43.0-94.9) whereas high NLR was 36 months (95% CI, 29.1-42.8). The median OS with low PLR patients was 76 months (95% CI, 46.4-105.5) and high PLR was 35 months (95% CI, 28.5-41.4). In serous tumors (70.7%), the median OS with low NLR and high NLR was 54 months (95% CI, 27.9-80.0) and 34 months (95% CI, 28.2-39.7), and for the median OS with low PLR and high PLR it was 51 months (95% CI, 21.2-80.7) and 35 months (95% CI, 27.8-42.1), respectively. Conclusion: The present findings showed that the high NLR and high PLR were associated with poor prognosis and these values are significantly remarkable in EOC patients.
Neutrophil-to-lymphocyte ratio; Platelet-to-lymphocyte ratio; Overall survival.
Y. Yildiz, Y. Kucukzeybek, A. Alacacioglu, U. Varol, I. Yildiz, M. Akyol, G. Kabadayı, H. Taskaynatan, T. Salman, V. Bayoglu, U. Oflazoglu, M.o. Tarhan. Prognostic value of preoperative neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in patients with epithelial ovarian cancer. European Journal of Gynaecological Oncology. 2017; 38(3): 444-448. doi: 10.12892/ejgo3402.2017
[1] Siegel R., Naishadham D., Jemal A.: “Cancer statistics, 2012”. CA Cancer J. Clin., 2012, 62, 10.
[2] Colotta F., Allavena P., Sica A., Garlanda C., Mantovani A.: “Cancer- related inflammation, the seventh hallmark of cancer: links to genetic instability”. Carcinogenesis, 2009, 30, 1073.
[3] Forrest L.M., McMillan D.C., McArdle C.S., Angerson W.J., Dunlop D.J.: “Evaluation of cumulative prognostic scores based on the systemic inflammatory response in patients with inoperable nonsmall- cell lung cancer”. Br. J. Cancer, 2003, 89, 1028.
[4] Dirican A., Kucukzeybek B.B., Alacacioglu A., Kucukzeybek Y., Erten C., Varol U., et al.: “Do the derived neutrophil to lymphocyte ratio and the neutrophil to lymphocyte ratio predict prognosis in breast cancer?” Int. J. Clin. Oncol., 2014, 20, 70.
[5] Jiang R., Zou X., Hu W., Fan Y.Y., Yan Y., Zhang M.X., et al.: “The elevated pretreatment platelet-to-lymphocyte ratio predicts poor outcome in nasopharyngeal carcinoma patients”. Tumour Biol., 2015, 36, 7775.
[6] Kim E.Y., Lee J.W., Yoo H.M., Park C.H., Song K.Y.: “The Plateletto- Lymphocyte Ratio Versus Neutrophil-to-Lymphocyte Ratio: Which is Better as a Prognostic Factor in Gastric Cancer? Ann Surg Oncol., 2015, 22, 4363.
[7] Dirican A., Kucukzeybek Y., Erten C., Somali I., Demir L., Can A., et al.: “Prognostic and predictive value of hematologic parameters in patients with metastatic renal cell carcinoma: second line sunitinib treatment following IFN-alpha”. Asian Pac. J. Cancer Prev., 2013, 14, 2101.
[8] Xue T.C., Jia Q.A., Ge N.L., Zhang B.H., Wang Y.H., Ren Z.G., Ye S.L. : “The platelet-to-lymphocyte ratio predicts poor survival in patients with huge hepatocellular carcinoma that received transarterial chemoembolization”. Tumour Biol., 2015, 36, 6045.
[9] Wuxiao Z.J., Zhou H.Y., Wang K.F., Chen X.Q., Hao X.B., Lu Y.D., Xia Z.J.: “A prognostic model to predict survival in stage III colon cancer patients based on histological grade, preoperative carcinoembryonic antigen level and the neutrophil lymphocyte ratio”. Asian Pac. J. Cancer Prev., 2015, 16, 747.
[10] Inoue D., Ozaka M., Matsuyama M., Yamada I., Takano K., Saiura A., Ishii H.: “Prognostic value of neutrophil-lymphocyte ratio and level of C-reactive protein in a large cohort of pancreatic cancer patients: a retrospective study in a single institute in Japan”. Jpn. J. Clin. Oncol., 2014, 45, 61.
[11] Dirican A., Varol U., Kucukzeybek Y., Alacacioglu A., Erten C., Somali I., et al.: “Treatment of metastatic colorectal cancer with or without bevacizumab: can the neutrophil/lymphocyte ratio predict the efficiency of bevacizumab?” Asian Pac. J. Cancer Prev., 2014, 15, 4781.
[12] Raungkaewmanee S., Tangjitgamol S., Manusirivithaya S., Srijaipracharoen S., Thavaramara T.: “Platelet to lymphocyte ratio as a prognostic factor for epithelial ovarian cancer”. J. Gynecol. Oncol., 2012, 23, 265.
[13] Asher V., Lee J., Innamaa A., Bali A.: “Preoperative platelet lymphocyte ratio as an independent prognostic marker in ovarian cancer”. Clin. Transl. Oncol., 2011, 13, 499.
[14] Williams K.A., Labidi-Galy S.I., Terry K.L., Vitonis A.F., Welch W.R., Goodman A., Cramer D.W.: “Prognostic significance and predictors of the neutrophil-to-lymphocyte ratio in ovarian cancer”. Gynecol. Oncol., 2014, 132, 542.
[15] Yildirim M., Demir Cendek B., Filiz Avsar A.: “Differentiation between benign and malignant ovarian masses in the preoperative period using neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios”. Mol Clin Oncol., 2015, 3, 317.
[16] Pistelli M., De Lisa M., Ballatore Z., Caramanti M., Pagliacci A., Battelli N., et al.: “Pre-treatment neutrophil to lymphocyte ratio may be a useful tool in predicting survival in early triple negative breast cancer patients”. BMC Cancer, 2015, 15, 195.
[17] Rachidi S., Wallace K., Wrangle J.M., Day T.A., Alberg A.J., Li Z.: “Neutrophil-to-lymphocyte ratio and overall survival in all sites of head and neck squamous cell carcinoma”. Head Neck, 2015, doi: 10.1002/hed.24159. [Epub ahead of print]
[18] Kang M.H., Go S.I., Song H.N., Lee A., Kim S.H., Kang J.H., et al.: “The prognostic impact of the neutrophil-to-lymphocyte ratio in patients with small-cell lung cancer”. Br. J. Cancer, 2014, 111, 452.
[19] Sadik C.D., Kim N.D., Luster A.D.: “Neutrophils cascading their way to inflammation”. Trends Immunol., 2011, 32, 452.
[20] Miskolci V., Rollins J., Vu H.Y., Ghosh C.C., Davidson D., Vancurova I.: “NFkappaB is persistently activated in continuously stimulated human neutrophils”. Mol. Med., 2007, 13, 134.
[21] Krenn-Pilko S., Langsenlehner U., Thurner E.M., Stojakovic T., Pichler M., Gerger A., et al.: “ The elevated preoperative plateletto- lymphocyte ratio predicts poor prognosis in breast cancer patients”. Br. J. Cancer, 2014, 110, 2524.
[22] Leitch E.F., Chakrabarti M., Crozier J.E., McKee R.F., Anderson J.H., Horgan P.G., McMillan D.C.: “Comparison of the prognostic value of selected markers of the systemic inflammatory response in patients with colorectal cancer”. Br. J. Cancer, 2007, 97, 1266.
[23] Azab B., Shah N., Radbel J., Tan P., Bhatt V., Vonfrolio S., et al.: “Pretreatment neutrophil/lymphocyte ratio is superior to platelet/lymphocyte ratio as a predictor of long-term mortality in breast cancer patients”. Med. Oncol., 2013, 30, 432.
[24] Dunn G.P., Old L.J., Schreiber R.D.: “The immunobiology of cancer immunosurveillance and immunoediting”. Immunity, 2004, 21, 137.
[25] Ikeda M., Furukawa H., Imamura H., Shimizu J., Ishida H., Masutani S., et al.: “Poor prognosis associated with thrombocytosis in patients with gastric cancer”. Ann. Surg. Oncol., 2002, 9, 287.
[26] Solinas G., Marchesi F., Garlanda C., Mantovani A., Allavena P.: “Inflammation-mediated promotion of invasion and metastasis”. Cancer Metastasis Rev., 2010, 29, 243.
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