Prognostic value of changes in neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and lymphocyte-to-monocyte ratio (LMR) for patients with cervical cancer undergoing definitive chemoradiotherapy (dCRT)

Trinh, Hamilton; Dzul, Stephen P.; Hyder, J.; Jang, Hyejeong; Kim, Seongho; Flowers, J.; Vaishampayan, Neil; Chen, Jerry; Winer, Ira; Miller, Steven

doi:10.1016/j.cca.2020.09.008

Cited by 44 publications

(34 citation statements)

References 37 publications

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“…Considering the imbalance of cell function ( 4 – 6 ). It is useful to noting that more and more scholars pay more attention to the inflammatory indicators that can reflect the whole body, such as platelet/lymphocyte ratio (PLR), lymphocyte/neutrophil ratio (NLR) and lymphocyte/monocyte ratio (LMR) ( 7 , 8 ). However, this inflammation-based biomarker integrates only two kinds of immune cells.…”

Section: Introductionmentioning

confidence: 99%

The Relationship Between Preoperative Systemic Immune Inflammation Index and Prognostic Nutritional Index and the Prognosis of Patients With Alveolar Hydatid Disease

et al. 2021

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BackgroundTo explore the relationship between the preoperative immune inflammation index (SII) and the prognostic nutritional index (PNI) and the overall survival rate (OS) of patients with alveolar hydatid disease.MethodsThe clinical data of patients with hepatic alveolar echinococcosis treated by surgery in the Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Qinghai University from January 2015 to January 2019 were analyzed retrospectively, and the SII, PNI, PLR and NLR were calculated. Spearman correlation analysis was utilized to analyze the correlation among SII, PNI, PLR and NLR. Receiver operating characteristic curve (ROC) was utilized to determine the best intercept values of SII, PNI, PLR and NLR, and Chi-square test was used to evaluate the relationship between SII, PNI and various clinicopathological features in patients with hepatic alveolar echinococcosis. The kaplan-Meier method was used to draw survival curves and analyze the relationship between them and the total survival time of patients. A cox regression model was used to analyze the relationship between SII, PNI and the prognosis of patients with hepatic alveolar echinococcosis. Finally, ROC curve was used to estimate the predictive efficacy of SII, PNI and COSII-PNI for the prognosis of patients with hepatic alveolar echinococcosis.ResultsA total of 242 patients were included, including 96 males and 146 females, aged 11.0-67.0 (36.6 ± 11.7) years. The values of SII, PNI, PLR and NLR are calculated, and the best truncation values of SII, PNI, PLR and NLR are given in ROC curve. The kaplan-Meier survival curve was used to analyze the relationship between SII, PNI, PLR, NLR and the overall survival time of patients with hepatic alveolar echinococcosis. The results showed that the median follow-up time was 45 months (95%CI: 39.484-50.516), and the average survival time was 49 months (95%CI: 47.300-51.931), which was low p<0.001); The 5-year OS rate of low PNI was significantly lower than that of high PNI group (37.7% vs 71.6%; p<0.001); The 5-year OS rate in low PLR group was significantly higher than that in high PLR group (70.4% vs 24.3%; p<0.001); The 5-year OS rate in low NLR group was significantly higher than that in high NLR group (67.2% vs 28.8%; p<0.001). Cox unifoliate analysis showed that SII, PNI, PLR and NLR were important prognostic factors related to OS. Cox multivariate analysis showed that SII(HR=4.678, 95% CI: 2.581-8.480, P<0.001) and PNI(HR=0.530, 95%CI: 0.305-0.920, P<0.05) were identified as independent risk indicators of OS, while NL was identified as independent risk indicators of OS ROC curve analysis showed that AUC of SII, PNI, PLR, NLR and COSII-PNI were 0.670(95%CI: 0.601-0.738), 0.638(95%CI: 0.561-0.716) and 0.618(95% CI: 0.541-0.694), respectively COSII-PNI is superior to SII and PNI in evaluating prognosis (P < 0.05).ConclusionsSII and PNI can be regarded as independent risk factors reflecting the prognosis of patients with hepatic alveolar echinococcosis. The lower SII and the higher PNI before operation, the better the prognosis of patients, and the combined application of SII and PNI before operation can improve the accuracy of prediction.

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Section: Introductionmentioning

confidence: 99%

The Relationship Between Preoperative Systemic Immune Inflammation Index and Prognostic Nutritional Index and the Prognosis of Patients With Alveolar Hydatid Disease

et al. 2021

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“…Focusing on the host factors, high serum CRP levels, low serum albumin levels, high CAR, high ANC, and high NLR were significant risk factors for poor OS in the univariate analyses (Table 2). In addition to CAR and NLR, several other inflammation‐based markers, such as monocyte‐to‐lymphocyte ratio (MLR), platelet‐to‐lymphocyte ratio (PLR), and prognostic nutritional index (PNI), have been regarded as prognostic markers of cervical cancer 31–33 . All of them can reflect systemic inflammation as well as radiation‐induced lymphopenia.…”

Section: Resultsmentioning

confidence: 99%

High neutrophil‐to‐lymphocyte ratio is a predictor of short‐term survival for patients with recurrent cervical cancer after radiation‐based therapy

Taguchi

Nakajima

Furusawa

et al. 2021

J of Obstet and Gynaecol

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Aim Patients with recurrent cervical cancer after radiotherapy have poor prognoses because of the lack of effective treatment options. Biomarkers to predict survival outcomes for recurrent cervical cancer are warranted because patients with limited life expectancy sometimes benefit from less aggressive treatment in combination with early palliative care. Therefore, we aimed to explore a predictive biomarker for the outcomes of patients with recurrent cervical cancer. Methods We retrospectively investigated 231 patients initially treated with radiation‐based therapy between January 2004 and December 2015. The associations between clinicopathological features at the time of relapse and overall survival after relapse were assessed. As factors which reflect patients' conditions, we particularly focused on C‐reactive protein‐to‐albumin ratio (CAR) and neutrophil‐to‐lymphocyte ratio (NLR) at the time of relapse. Additionally, we investigated biomarkers predictive of short‐term survival. Results Among 231 patients, 91 patients experienced relapse and 74 patients died during the follow‐up period. Multivariate analysis revealed that treatment after relapse, CAR, and NLR was significantly associated with overall survival. Among them, treatment after relapse significantly affected survival outcomes, and patients who received definitive local treatment had a better 3‐year survival rate than those who received other treatments. Conversely, NLR was the most influential biomarker for short‐term survival, and the prognosis of patients with high NLRs was much worse than those with low NLRs. Conclusions This study thus demonstrated that, for the patients with recurrent cervical cancer who received radiation‐based therapy, definitive local treatment can provide long‐term survival and extremely high NLRs are predictive of short‐term survival.

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“…Therefore, high NLR and PLR may indicate tumor aggressiveness and host immunity. Several studies have been conducted to evaluate NLR and/or PLR as prognostic factors in cervical cancer [11,13,14,[19][20][21][22][23][24][25]. The studies, listed in Table 5 show the connection between prognosis in cervical cancer patients and NLR and/or PLR.…”

Section: Discussionmentioning

confidence: 99%

Pretreatment Neutrophil-to-Lymphocyte Ratio Combined with Platelet-to-Lymphocyte Ratio as a Predictor of Survival Outcomes after Definitive Concurrent Chemoradiotherapy for Cervical Cancer

Lee

Seol

2021

JCM

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The aim of the study was to evaluate pretreatment neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as prognostic factors for predicting clinical outcomes after definitive concurrent chemoradiotherapy (CCRT) for cervical cancer. The cases were divided into two groups based on the values of NLR and PLR: High NLR-PLR (high value in both NLR and PLR) and Low NLR-PLR (low value in either NLR or PLR). The relationships between survival outcomes and the pretreatment NLR-PLR were investigated. Of the 148 patients enrolled in the study, 30 patients died during the median follow-up of 75 months. Based on receiver operating curves, NLR and PLR cut-off values for survival analysis were 2.34 and 148.89. The 10-year overall survival and disease-free survival rates for high NLR-PLR vs. low NLR-PLR were 63.6% vs. 86.2% (p = 0.001) and 63.3% vs. 77.5% (p = 0.026), respectively. Based on a multivariate analysis, independent predictors of overall survival were high NLR-PLR (hazard ratio [HR], 2.435; 95% confidence interval [CI], 1.106–5.361; p = 0.027) and stage (HR 2.659; 95% CI, 1.146–6.613; p = 0.024). Increases in both NLR and PLR are associated with poor survival. Elevation in both NLR and PLR before initiation of CCRT may be a useful biomarker for predicting clinical outcomes.

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Prognostic value of changes in neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and lymphocyte-to-monocyte ratio (LMR) for patients with cervical cancer undergoing definitive chemoradiotherapy (dCRT)

Cited by 44 publications

References 37 publications

The Relationship Between Preoperative Systemic Immune Inflammation Index and Prognostic Nutritional Index and the Prognosis of Patients With Alveolar Hydatid Disease

The Relationship Between Preoperative Systemic Immune Inflammation Index and Prognostic Nutritional Index and the Prognosis of Patients With Alveolar Hydatid Disease

High neutrophil‐to‐lymphocyte ratio is a predictor of short‐term survival for patients with recurrent cervical cancer after radiation‐based therapy

Pretreatment Neutrophil-to-Lymphocyte Ratio Combined with Platelet-to-Lymphocyte Ratio as a Predictor of Survival Outcomes after Definitive Concurrent Chemoradiotherapy for Cervical Cancer

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