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Original Research

Open Access

Pretreatment anemia status and elevated PLR affect the prognosis of locally advanced cervical squamous cell carcinoma patients treated with concurrent chemoradiotherapy

  • Meilian Dong1
  • Yonggang Shi1,*,

1Department of Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, 450052 Zhengzhou, Henan, China

DOI: 10.22514/ejgo.2022.005 Vol.43,Issue 3,June 2022 pp.103-110

Submitted: 18 February 2022 Accepted: 22 March 2022

Published: 15 June 2022

*Corresponding Author(s): Yonggang Shi E-mail:


Objective: To assess the prognostic value of platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and systemic immune-inflammation index (SII) in locally advanced cervical squamous cell carcinoma (LACSC) treated with concurrent chemoradiotherapy (CCRT) regimens. Methods: The contribution of systemic immune inflammatory response markers (NLR, PLR, LMR, SII), inflammatory cells (lymphocytes, neutrophils, monocytes, platelets), and hematocrit in predicting the outcomes of concurrent chemoradiotherapy treatment in LACSC patients was examined using the Kaplan-Meier univariate survival analysis method. Variables that were significant for the univariate analysis were included in the multivariate regression analysis to confirm the independent prognostic factors affecting concurrent chemoradiotherapy in LACSC patients. Results: Univariate analysis showed that age (p = 0.024), PLR (p = 0.007), NLR (p = 0.089), LMR (p = 0.021), SII (p = 0.087), and Hb (p = 0.004) were all prognostic factors affecting OS (over survival). Multivariate regression analysis revealed that PLR (p = 0.066) and Hb (p = 0.045) before concurrent chemoradiotherapy were independent risk factors of OS in the studied population. Moreover, these two factors were significantly correlated (correlation coefficient Rs = –0.426, p = 0.000). Conclusions: The results suggested that elevated PLR and anaemia are likely to have poorer prognoses in LACSC patients who initially received radical CCRT. Moreover, pre-treatment anemia status may exacerbate the prognostic effects of PLR.


Locally advanced cervical cancer; Concurrent chemoradiotherapy; Prognosis; Systemic immune inflammatory index; Anemia

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Meilian Dong,Yonggang Shi. Pretreatment anemia status and elevated PLR affect the prognosis of locally advanced cervical squamous cell carcinoma patients treated with concurrent chemoradiotherapy. European Journal of Gynaecological Oncology. 2022. 43(3);103-110.


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