Prognostic Use of Pretreatment Hematologic Parameters in Patients Receiving Definitive Chemoradiotherapy for Cervical Cancer

Onal, Cem; Güler, Ozan Cem; Yıldırım, Berna Akkuş

doi:10.1097/igc.0000000000000741

Cited by 40 publications

(57 citation statements)

References 32 publications

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“…These studies came from China [25, 27, 29, 30, 32–36], Korea [37], Japan [26, 31], and Turkey [28], respectively. Twelve articles reported the outcomes of overall survival (OS) [25–33, 35–37], and 10 studies presented progression-free survival (PFS) as primary outcome [26–28, 31–37]. The hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs) were obtained by multivariate analyses in 8 studies and through univariate or Kaplan–Meier curves in 5 studies [25–27, 34, 36].…”

Section: Resultsmentioning

confidence: 99%

“…The hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs) were obtained by multivariate analyses in 8 studies and through univariate or Kaplan–Meier curves in 5 studies [25–27, 34, 36]. Five studies included CC patients with all disease stages (Stages I–IV) [26, 28, 31, 33, 37], seven studies recruited patients with Stages I–II [25, 29, 30, 32, 34–36] and only one study reported the data of CC patients with Stages II–III [27]. The primary treatments were extremely various among the 13 included studies, including concurrent chemoradiotherapy (CCRT) [26–28], surgery with neoadjuvant chemotherapy (NACT) [30, 36], surgery with adjuvant therapy (AT) [25, 29, 32, 35], surgery alone [34], radiotherapy or CCRT [31, 33], and mixed treatments [37].…”

Section: Resultsmentioning

confidence: 99%

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Prognostic value of the pretreatment neutrophil-to-lymphocyte ratio in cervical cancer: a meta-analysis and systematic review

et al. 2017

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The prognostic value of pretreatment neutrophil-to-lymphocyte ratio (NLR) in cervical cancer remains controversial. We conducted a meta-analysis based on the data from 13 studies with 3729 patients to evaluate the association between the pretreatment NLR and the clinical outcomes of overall survival and progression-free survival in patients with cervical cancer. The relationship between NLR and clinicopathological parameters was also assessed. Hazard ratio (HR) or odds ratio (OR) with its 95% confidence interval (CI) was used as the effect size estimate. Our analysis indicated that elevated pretreatment NLR was a poor prognostic marker for patients with cervical cancer because it predicted unfavorable overall survival (HR = 1.375, 95% CI: 1.200–1.576) and progression-free survival (HR = 1.646, 95% CI: 1.313–2.065). Increased NLR is also significantly associated with the larger tumor size (OR = 1.780, 95% CI: 1.090–2.908), advanced clinical stage (OR = 2.443, 95% CI: 1.730–3.451), and positive lymph node metastasis (OR = 2.380, 95% CI: 1.775–3.190). By these results, high pretreatment NLR predicted a shorter survival period for patients with cervical cancer, and it could be served as a novel index of prognostic evaluation in patients with cervical cancer.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Prognostic value of the pretreatment neutrophil-to-lymphocyte ratio in cervical cancer: a meta-analysis and systematic review

et al. 2017

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“…Lymphocytes are involved at various steps of host response to cancer, and may modulate response to treatment [14,15]. Lymphopenia and decreased ratio of lymphocytes to neutrocytes or platelets might be prognostic factor in survival for various cancer types [16][17][18][19]. Moreover pretreatment lymphopenia was proposed to predict survival and early death after chemotherapy for breast cancer, lymphomas and sarcomas [20,21].…”

Section: Rt and Immunitymentioning

confidence: 99%

Bone marrow sparing RT in era of immunotherapy

Kuncman¹,

Pietrzykowska-Kuncman²,

Danielska³

et al. 2018

Nowotwory. Journal of Oncology

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Recent advances in the field of immunotherapy have changed the perception of cancer treatment to complex model with host immunity in the spotlight. Potential synergy of immunotherapy drugs [aiming cytotoxic T cell antigen 4 (CTLA-4) or programmed cell death-1/ligand (PD-1/PD-L1)] and radiotherapy (RT) have established basis for ongoing clinical trials testing combined treatment. It was shown that complete blood cell counts (CBC) parameters may correlate with cancer survival, toxicity and outcomes of treatment. Therefore, reduction of hematologic toxicity of cancer treatment may gain in significance. Modern dose delivery techniques compromise dose reduction in critical organs (like bone marrow-BM) with adequate irradiation of target volumes. In addition, usage of modern imaging like positron emission tomography (PET), magnetic resonance imaging (MRI) allows to divide the volume of BM to active and inactive one. In this review, we discuss the synergy of RT and immunity and techniques of Bone Marrow Sparing RT (BMS-RT).

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“…Among these pretreatment blood parameters, the peripheral neutrophil-lymphocyte ratio (NLR), calculated as the absolute neutrophil count (ANC) divided by the absolute lymphocyte count (ALC), is regarded as a simple and effective marker of inflammation 23 - 25 that has been consistently reported to have an independent prognostic value in various tumors 21 , 22 , 26 . An increased NLR was associated with advanced stages of cervical neoplasia 27 , 28 , and patients with a higher histologic grade of CIN showed higher numbers of total leukocytes 29 .…”

Section: Introductionmentioning

confidence: 99%

The Neutrophil-Lymphocyte Ratio Predicts Recurrence of Cervical Intraepithelial Neoplasia

Chun¹,

Shin²,

Kim³

et al. 2017

J. Cancer

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OBJECTIVE: The purpose of the present study was to determine the prognostic significance of the neutrophil-lymphocyte ratio (NLR) in recurrence of cervical intraepithelial neoplasia (CIN).METHODS: We evaluated the NLR as a prognostic marker in the entire cohort of 230 patients who had undergone surgical resection and were diagnosed with CIN. Subjects were categorized into two different groups based on the NLR (NLR-high and NLR-low) using cutoff values determined by receiver operating characteristic (ROC) analysis. The primary research objective for this study was to validate the impact of the NLR on recurrence-free survival (RFS) in patients with CIN. The secondary objective was to evaluate the impact of other hematologic parameters on RFS in CIN patients.RESULTS: Using the entire cohort, the most appropriate NLR cut-off value for CIN recurrence selected on the ROC curve was 2.1. The NLR-low and NLR-high groups included 167 (72.6%) and 63 patients (27.4%), respectively. According to Kaplan-Meier analysis, RFS rates during the entire follow-up period were considerably lower in the NLR-high group than in the NLR-low group (P = 0.0125). In multivariate survival analysis using Cox proportional hazard model, we identified the NLR, absolute eosinophil count (AEC), hemoglobin concentration, and mean corpuscular volume (MCV) as valuable prognostic factors that impact RFS.CONCLUSIONS: The NLR is an independent prognosticator for RFS following surgical resection in CIN patients. We also found that the AEC, hemoglobin level, and MCV were strongly associated with RFS, as determined by multivariate analysis using a Cox model. These hematological parameters might provide additional prognostic value beyond that offered by standard clinicopathologic parameters.

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Prognostic Use of Pretreatment Hematologic Parameters in Patients Receiving Definitive Chemoradiotherapy for Cervical Cancer

Cited by 40 publications

References 32 publications

Prognostic value of the pretreatment neutrophil-to-lymphocyte ratio in cervical cancer: a meta-analysis and systematic review

Prognostic value of the pretreatment neutrophil-to-lymphocyte ratio in cervical cancer: a meta-analysis and systematic review

Bone marrow sparing RT in era of immunotherapy

The Neutrophil-Lymphocyte Ratio Predicts Recurrence of Cervical Intraepithelial Neoplasia

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