Preoperative Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio Are Not Clinically Useful in Predicting Prognosis in Early Stage Cervical Cancer

Abstract

Background An objective of this study was to determine the prognostic role of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in patients with cervical cancer (CC) stages IA2-IB1. Methods The study included 484 patients who underwent radical hysterectomy with pelvic node dissection. The associations of preoperative NLR and PLR with clinicopathologic characteristics and oncological outcomes were analyzed. The cut-off values of NLR (=1.8) and PLR (=119) were set as medians. Results The clinicopathologic analysis showed that NLR was associated with age (p=0.010), tumor size (p=0.045), and adjuvant treatment (p=0.005), and PLR was associated with only adjuvant treatment (p=0.033). DFS and OS were not significantly different between patients with high and low NLR (p=0.670 and p=0.934) or high and low PLR (p=0.780 and p=0.306). The independent prognostic factors associated with OS were lymph node status and anemia, and with DFS were histology, deep stromal invasion, and lymph node status. Conclusions NLR and PLR have no use as prognostic biomarker for DFS and OS in early-stage CC. However, NLR and PLR might be of use in determining the risk for adjuvant treatment.

RETRACTED ARTICLE: Exosomal lncRNA HNF1A-AS1 affects cisplatin resistance in cervical cancer cells through regulating microRNA-34b/TUFT1 axis

“…There is a possible impact of genetic factors to the risk of HPV infection progression to cervical precancer and CC [5]. It has been suggested that the standard primary treatment of CC includes radiotherapy (RT), or radical hysterectomy with pelvic lymph node dissection (RHND), or a combination of RT and platinum-based chemotherapy [6]. Cisplatin (DDP) is a widely-used potent chemotherapeutic drug for the treatment of CC, while its effectiveness is restricted by the resistance development [6].…”

“…It has been suggested that the standard primary treatment of CC includes radiotherapy (RT), or radical hysterectomy with pelvic lymph node dissection (RHND), or a combination of RT and platinum-based chemotherapy [6]. Cisplatin (DDP) is a widely-used potent chemotherapeutic drug for the treatment of CC, while its effectiveness is restricted by the resistance development [6]. Consequently, the recognition of novel prognostic markers might be helpful for offering more personalized medical treatment for CC.…”

Neutrophil-to-lymphocyte ratio is an independent predictor for survival outcomes in cervical cancer: a systematic review and meta-analysis

“…We found that the pretreatment NLR was significantly associated with tumor grade, advanced FIGO stage, LVSI, LN metastasis and recurrence, which would influence the alternative of therapy strategies. These results are consistent with studies showing that neutrophilia and leukocytosis are associated to worse outcomes in patients with locally advanced and recurrent cervical cancer 29 – 31 , 46 – 48 .…”

“…Fourteen studies comprising 6041 patients with cervical cancer were included 20 , 29 – 41 . Characteristics of included studies are described in Table 1 .…”

“…The major reason why we didn’t conduct a sub-analysis on stage is that there were only three included studies focused on early-staged patients (Seen in Table 1 : Nuchpramool et al 29 FIGO Stage: IA2-IB1; Chen et al 38 FIGO Stage: IB1–IIA; Zhang et al 40 FIGO Stage: I–II) and one focused on FIGO Stage II–III, while other studies reported mixed data of patients staged I–IV. As we all know, the initial treatment is mostly decided by the stage.…”