Prognostic value of neutrophil-to-lymphocyte ratio in early-stage ovarian clear-cell carcinoma

Abstract

ObjectivesThere is increasing evidence that systemic inflammatory response (SIR) markers are prognostic factors for various types of cancers. This is the first study to evaluate the usefulness of SIR markers for the prognosis of early-stage ovarian clear-cell carcinoma (OCCC).MethodsWe retrospectively investigated 83 patients diagnosed with stage I–II OCCC who underwent surgery between 2005 and 2017. Initially, receiver operating characteristic curve analysis for overall survival (OS) was used to determine optimal cut-off values for neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). Patients were stratified into 2 groups by the cut-off values (NLR=3.26, PLR=160). Univariate and multivariate analyses were performed to elucidate the significance of SIR markers as prognostic factors.ResultsIn the median follow-up period of 64.1 months, 16 patients experienced recurrence, and nine patients died. The Kaplan-Meier curve showed that OS of the NLR-low group was significantly longer than the NLR-high group (p=0.021). There was no significant difference in progression-free survival between the 2 groups (p=0.668), but the post-recurrence survival of the NLR-low group was significantly longer than the NLR-high group (p=0.019). Furthermore, multivariate analysis showed that increase in NLR is a significant independent prognostic factor for poor prognosis (hazard ratio=7.437, p=0.017). There was no significant difference between PLR-low and PLR-high group.ConclusionResults suggest that NLR can be a significant independent prognostic factor for early-stage OCCC.

Serum D-dimer, Albumin and Systemic Inflammatory Response Markers in Ovarian Clear Cell Carcinoma and Their Prognostic Implications

“…Four studies on the effectiveness of SIR markers in OCCC patients have been reported in the last ve years, as shown in Table 4. Concerning NLR, most of the previous reports suggested that NLR was a prognostic indicator for PFS and/or OS [13,19,20] . There are some con icting results regarding PLR.…”

“…Summary of studies examining SIR as prognostic factors in OCCC patients. Kim 2016 [19] Zhang 2017 [20] Kwon 2018 [12] Yoshida 2019 [13] The present study…”

“…Plasma D-dimer levels, which are signi cantly elevated in patients with OCCC, are associated with the incidence of deep venous thrombosis [7] as well as clinical progression and poor prognosis in malignancies, including ovarian cancer [8,9] . Numerous studies have shown that elevated NLR is linked to poor prognosis among patients with solid tumors, including gynecologic cancers [10,11] , and markers of systemic in ammatory response could provide useful prognostic information of overall survival in patients with OCCC [12,13] .…”

Serum D-dimer, Albumin and Systemic Inflammatory Response Markers in Ovarian Clear Cell Carcinoma and Their Prognostic Implications

“…There are four studies on the effectiveness of SIR markers in OCCC patients in the last five years, as shown in Table 4. Concerning NLR, most of the previous reports suggested that NLR was a prognostic indicator for PFS and/or OS [13,19,20] . There are some conflicting results regarding PLR, with one study suggesting that high PLR was associated with unfavorable outcomes, advanced stage, resistance to primary treatment and decreased survival [19] , while others did not.…”

“…The plasma D-dimer level, which significantly elevates in patients with OCCC, was associated with the incidence of deep venous thrombosis [7] as well as clinical progression and poor prognosis in malignancies including ovarian cancer [8,9] . Plenty of studies have shown that elevated NLR is linked to poor prognosis among patients with solid tumors including gynecologic cancers [10,11] , and markers of systemic inflammatory response could provide useful prognostic information of overall survival in patients with OCCC [12,13] .…”