The Lymphocyte-Monocyte Ratio Predicts Patient Survival and Aggressiveness of Ovarian Cancer

Abstract

Objective: To measure the prognostic value of the lymphocyte-monocyte ratio (LMR) in patients with epithelial ovarian cancer (EOC).Methods: We retrospectively examined the LMR as a prognosticator in a cohort of 234 patients with EOC who underwent surgical resection. Patients were categorized into two different groups based on the LMR (LMR-low and LMR-high) using cut-off values determined by receiver operating characteristic (ROC) curve analysis. The objective of the study was to assess the effect of the LMR on progression-free survival (PFS) and overall survival (OS), and to validate the LMR as an independent predictor of survival.Results: Using the data collected from the whole cohort, the optimized LMR cut-off value selected on the ROC curve was 2.07 for both PFS and OS. The LMR-low and LMR-high groups included 48 (20.5%) and 186 patients (79.5%), respectively. The 5-year PFS rates in the LMR-low and LMR-high groups were 40.0 and 62.5% (P < 0.0001), respectively, and the 5-year OS rates in these two groups were 42.2 and 67.2% (P < 0.0001), respectively. On multivariate analysis, we identified age, International Federation of Gynecology and Obstetrics (FIGO) stage, and cancer antigen 125 levels to be the strongest valuable prognostic factors affecting PFS (P = 0.0421, P = 0.0012, and P = 0.0313, respectively) and age, FIGO stage, and the LMR as the most valuable prognostic factors predicting OS (P = 0.0064, P = 0.0029, and P = 0.0293, respectively).Conclusion: The LMR is an independent prognostic factor affecting the survival of patients with EOC.

Prognostic significance of platelet‐to‐lymphocyte ratio in patients with ovarian cancer: A meta‐analysis

“…9 A recent metaanalysis has shown that high NLR is associated with F I G U R E 2 Forest plots for the association between platelet-to-lymphocyte ratio (PLR) and overall survival (OS) decreased OS and DFS in patients with gynaecological cancers, and its prognostic value is consistent among patients with ovarian, cervical and endometrial cancers. 24,26,28 Miao et al found that elevated pretreatment PLR is predictive of poor OS and PFS among patients with ovarian cancer. 24,26,28 Miao et al found that elevated pretreatment PLR is predictive of poor OS and PFS among patients with ovarian cancer.…”

Combined Plasma Fibrinogen and Neutrophil Lymphocyte Ratio in Ovarian Cancer Prognosis May Play a Role?

“…27 Conversely, lymphocytes induce cytotoxic cell death and suppress tumor cell proliferation and migration, which are important for defense against cancer proliferation and development. 28 In our population, in order to reduce bias toward overestimation of the prognostic role of NLR, we performed ROC curve analysis to determine the optimal cutoff point of pretreatment NLR and to recognize the most favorable NLR value able to guide the stratification for our cohort. Our findings are in accordance with other previously published studies with regard to improved platinum sensitivity for lower levels of NLR.…”

Peripheral blood lymphocyte-to-monocyte ratio as a prognostic factor in advanced epithelial ovarian cancer: a multicenter retrospective study

“…evaluated the prognostic significance of LMR in 234 EOC patients receiving primary debulking surgery 16. Their results showed that LMR cutoff value of 2.07, which was selected through the ROC curve analysis, can categorize the patients into two groups (low LMR and high LMR) with different survival outcomes 16. Similarly, LMR is a significant independent prognostic factor for OS, although it is not significant for predicting PFS.…”

“…Lymphocyte-to-monocyte ratio (LMR) has been shown to be a prognostic factor for patients with hepatocellular carcinoma and endometrial cancer 14, 15. Recently, one study showed that LMR predicts the survival and aggressiveness of malignancy of ovarian cancer patients who underwent primary debulking surgery 16. However, few studies have evaluated the prognostic significance of LMR in advanced EOC patients treated with neoadjuvant chemotherapy (NAC) followed by debulking surgery.…”