Prognostic value of preoperative lymphocyte-monocyte ratio in patients with ovarian clear cell carcinoma

Abstract

Objective: The aim of the present study was to determine the prognostic significances of markers of preoperative systemic inflammatory response (SIR) in patients with ovarian clear cell carcinoma (OCCC).Methods: A total of 109 patients diagnosed with OCCC that underwent primary cytoreductive surgery and adjuvant platinum-based chemotherapy from 2009 to 2012 were enrolled in this retrospective study. SIR markers were calculated from complete blood cell counts determined before surgery. Receiver operating characteristic (ROC) curve analysis was used to determine optimal cut-off values for neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR). Prognostic significances with respect to overall survival (OS) and progression-free survival (PFS) were determined by Kaplan-Meier curve and multivariate Cox regression analysis.Results: The optimized NLR, LMR and PLR cut-off values as determined by ROC curve analysis for PFS and OS were 2.3, 4.2, and 123.6, respectively. When the cohort was divided using these optimized cut-offs, NLR and LMR were found to be significantly associated with clinicopathologic factors, NLR with FIGO stage, the presence of malignant ascites, and platinum response, and LMR with FIGO stage, lymph node metastasis, malignant ascites, and platinum response. Kaplan-Meier analysis revealed a high NLR (> 2.3) was significantly associated with low 5-year PFS and OS rates and that a high LMR was significantly associated with high 5-year PFS and OS rates. Multivariate analysis identified FIGO stage, residual mass, and platinum response as independent prognostic factors of PFS, and FIGO stage, residual mass, platinum response, and LMR as independent prognostic factors of OS.Conclusions: Markers of systemic inflammatory response provide useful prognostic information and lymphocyte-to-monocyte ratio is the most reliable independent prognostic factor of overall survival in patients with ovarian clear cell carcinoma.

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

“…There was likewise no correlation between platinum resistance and preoperative lymphocyte count. So, PLR has nothing to do with resistance, and it is not related to survival which is consistent with most of the relevant studies [12,13,20] . Preoperative NLR level was associated with postoperative indicators such as FIGO stage, residual tumor and platinum resistance which are known prognostic factors in OCCC [5] .…”

“…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] .…”

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

“…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] .…”

The combination of serum NLR and D-dimer levels at diagnosis predicts overall survival in metastatic pancreatic cancer

“…Studies have shown that the prognosis of patients with cancers is associated with not only the characteristics of the tumor itself but also the systemic inflammatory response [2]. For instance, it is reported that a variety of routine inflammation-based prognostic scoring systems, like the NLR, PLR and lymphocyte-monocyte ratio (LMR), have prognostic significance for different tumors [3][4][5][6]. Hypercoagulability is another physiological change in cancer patients.…”