The Platelet to Lymphocyte and Neutrophil to Lymphocyte Ratios in Predicting Response to Platinum-based Chemotherapy for Epithelial Ovarian Cancer

Abstract

Objective: The patients with advanced-stage ovarian cancer have higher factors complicating surgery; thus, the best choice for them is surgery with chemotherapy with six cycles of adjuvant chemotherapy. Generally, chemotherapy can be evaluated in various ways, phsychal examination, radiology examination, and laboratory examination. This study aims is to examine if the measurement of the platelet/lymphocyte ratio (PLR) and neutrophil/lymphocyte ratio (NLR) can be used to predict a patient's response to chemotherapy. Methods: Analytic observational study with a case-control design conducted in the Dr. Hasan Sadikin Hospital in Bandung from 2017 to 2018. This study used the medical record of ovarian cancer patients with post-surgery complete blood counts and histopathological reports. The sample size was determined based on the categorical test's statistical calculation to obtain a total number of at minimal 90 samples. All the study subjects who had undergone complete chemotherapy were followed up for 6 months. Their response to chemotherapy was assessed with a clinical examination, ultrasonography, and a CA-125 blood test every 3 months. Results: In 2017-2018, 504 patients were diagnosed with ovarian cancer at the Dr. Hasan Sadikin Hospital in Bandung, Indonesia. After reassessment, 116 patients had stage I to III ovarian cancer and underwent cytoreduction followed by platinum chemotherapy. The age, cancer stage, and types of epithelial cells in the platinum-sensitive and platinum-resistant patients were characterized. There were significant differences between the two groups in age and cancer stage characteristics (p < 0.05). The increase in platelet/lymphocyte (p = 0.003) and neutrophil/lymphocyte ratios (p = 0.026) are associated with the increase in the response to platinum chemotherapy against epithelium-based cancers. Conclusion: A patient's NLR and PLR are strongly associated with his response to chemotherapy.

Neutrophil-to-lymphocyte Ratio as an Effective Biomarker for Meningioma: A Systematic Review and Meta-analysis

“…75 Numerous subsequent studies confirmed that an elevated NLR prior to surgery or treatment correlated with unfavorable surgical results, drug resistance, and decreased efficacies of immunotherapy and chemotherapy. [76][77][78][79] Elevated NLRs have been seen in both meningioma and gliomas, with a lack of significance attributed to extracranial influences of alternative inflammation sources. 43 The specific difference in NLR values for meningioma versus those of other brain pathologies has not been fully identified, so further research in meningioma is warranted moving forward.…”

Crosstalk of Immune Cells and Platelets in an Ovarian Cancer Microenvironment and Their Prognostic Significance

“…In patients who underwent debulking surgery, a high PLR had a negative correlation with DFS and OS [286]. Winarno et al discovered that a high post-operative PLR ratio of patients with an EOC was associated with an increase in the response to platinum-based chemotherapy [287]. Several researchers have also shown that PLR could play a predictive role in the early diagnosis and in distinguishing between benign and malignant tumors [269,270,288,289].…”