Prognostic value of neutrophil-to-leukocyte ratio in surgical outcomes of endometrial cancer

Background: Staging surgery for endometrial cancer poses significant risks of postoperative complications, impacting patient recovery and healthcare resources. Identifying reliable preoperative markers to predict these risks is crucial for optimizing patient care. The neutrophil-to-lymphocyte ratio (NLR), a simple inflammation marker derived from routine blood tests, has shown promise in various cancers but remains underexplored in gynecological oncology. This study investigates whether preoperative NLR and other blood parameters can predict short-term postoperative complications. Methods: A retrospective study was performed at a university-affiliated tertiary hospital, reviewing patients who underwent endometrial cancer staging surgery between 2016–2022. Short-term complications included blood transfusions, antibiotic use, intensive care unit (ICU) admissions, prolonged hospital stays, and hospital readmissions. Data collected encompassed demographics, comorbidities, surgical details, and preoperative complete blood count (CBC) results—specifically hemoglobin (Hb), platelet, and white blood cell (WBC) counts with differential, and NLR. Both univariable and multivariable analyses identified possible risk factors. Results: Out of 149 patients, 38 (25.5%) experienced at least one complication. Those with complications had significantly lower preoperative Hb levels (mean 11.8 vs. 13.3 g/dL, p < 0.001). An NLR >3 was significantly associated with complications (52.5% vs. 31.2%, p = 0.017) and was an independent risk factor (odds ratio (OR) 3.11, 95% confidence interval (CI) (1.01–9.52), p = 0.047). An additional risk was conversion to laparotomy (OR 13.7; 95%CI 1.77–106.38; p = 0.012). Conclusions: Preoperative CBC parameters, especially an NLR above 3, are significant independent predictors of short-term postoperative complications in endometrial cancer staging surgery. Incorporating routine NLR assessment could enhance preoperative risk stratification and targeted perioperative management. Further studies are necessary to validate these biomarkers and improve surgical outcomes.

Short-term surgical complications; Staging for endometrial cancer; Neutrophils-to-lymphocytes ratio

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