Comparison of clinical utilities of the platelet count and platelet-lymphocyte ratio for predicting survival in patients with cervical cancer: a single institutional study and literature review

Abstract

ObjectiveTo compare the clinical utilities of the platelet count and platelet-lymphocyte ratio (PLR) for predicting survival in patients with cervical cancer.ResultsMultivariate analyses demonstrated that thrombocytosis and elevated PLR were found to be independent prognostic factors for progression-free survival (PFS, P = 0.0077, P = 0.044) and overall survival (OS, P = 0.025, P = 0.019) in separate Multivariate analyses. In the ROC analysis, the platelet count showed a significantly greater area under the ROC curve (AUC) value than that of PLR for predicting patient recurrence (0.5941 versus 0.5331, p = 0.018) and survival (0.6139 versus 0.5468, p = 0.029). In patients without thrombocytosis, elevated PLR correlated with shorter survival (PFS, P = 0.041; OS, P = 0.017). In contrast, PLR in patients with thrombocytosis did not provide prognostic information. We divided patients into 3 prognostic groups using platelet counts and PLR: high-risk (thrombocytosis with any PLR); intermediate-risk (elevated PLR without thrombocytosis); low-risk (none of the above), which allowed for individualized and accurate survival estimates.Materials and MethodsThe baseline characteristics and clinical outcomes of cervical cancer patients were identified. Patients were grouped according to their pretreatment platelet counts or PLR, and clinicopathological characteristics and patient survival were then compared between these groups. The clinical utilities of the platelet count and PLR were compared using a time-dependent receiver operating characteristic (ROC) analysis.ConclusionsPretreatment thrombocytosis and elevated PLR were identified as independent predictors in cervical cancer patients. Platelet counts were superior to PLR for predicting the prognosis of uterine cervical cancer patients. Our prognostic model consisting of platelet counts and PLR offers individualized survival estimates.

Helical tomotherapy for chemo‐refractory multiple liver metastases

“…Therefore, irradiation to the normal liver using the TomoHelical mode might lead to increases in TGF‐β1 and Treg number, decreasing the efficacy of DC‐based vaccine therapy. It was reported that the pretreatment NLR, MLR, and PLR were associated with the prognosis of patients with malignant solid tumors . In a systematic review and meta‐analysis, NLR greater than 4 was associated with the poor prognosis, and this was also the case in our study.…”

“…14 Palliative 3DCRT against the whole liver has also been used for multiple liver metastases in the past in Japan. Generally, the liver is sensitive to radiation and up to [30][31][32][33][34][35] Gy against the whole liver is considered to be the safe limit. 15 These doses are not high enough to obtain long-term control of liver metastases.…”

Prognostic Significance of Thrombocytosis in Locally Advanced Carcinoma Cervix Patients Treated with Chemoradiotherapy

“…The patients with thrombocytosis had significantly poor OS and DFS of 41% and 39%, respectively at 5 years in our study. A similar trend was seen in all of the studies with chemoradiation (Table 3) (4,(10)(11)(12)16). The first study by Hernandez et al, in 1992, showed a 5-year-survival advantage of 65% in non-thrombocytosis versus 25% in patients with thrombocytosis.…”

“…Few studies on cervical cancer have assessed thrombocytosis as a prognostic indicator in patients receiving chemoradiation (5,(10)(11)(12)(13)(14)(15)(16). Two studies conducted by outcome.…”

“…Most studies that have investigated the prognostic implications of thrombocytosis in patients with cervical cancer have yielded contradictory results; few have shown positive correlation while others found no such correlation (4,5,(10)(11)(12)(13)(14)(15)(16). India has the largest burden of cervical cancer but there is a lack of studies regarding the incidence of thrombocytosis and its correlation with response and survival.…”