Abstract
This study was conducted to establish whether the preoperative platelet to lymphocyte ratio (PLR) is predictive of survival of women with ovarian clear cell carcinoma (OCCC). A PLR > 300 was deemed elevated. Progression-free survival (PFS) was estimated using the Kaplan-Meier method. Cox proportional hazard analysis was used to determine the independent effect of PLR. Thirty-six patients were reviewed. Elevated PLRs were more commonly noted in patients with an advanced vs an early stage of disease (88.9% vs 11.1%). Women with elevated PLR carried a higher rate of disease progression during primary therapy than that those in the normal PLR group (44.4 vs 22.2%). The median PFS for patients with elevated PLR was notably worse than that for patients with normal PLR (10 vs 34 months). Despite the impact of elevated PLR on PFS, it was found to be marginally significant when controlling for commonly applied prognostic markers. It, however, trended toward significance (HR=4.76; 95%CI, 0.95-23.8). In conclusion, an elevated PLR appears to be directly associated with adverse survival rather than being a surrogate for other indicators of a poor prognosis. PLR may be a useful biomarker for predicting survival of women with OCCC and merits further large-scale studies.
Highlights
Ovarian clear cell carcinoma (OCCC) is characterized by clear cells growing in a solid/tubular or glandular pattern, as well as hobnail cells (Tavassoli and Deville, 2003)
This study was conducted to establish whether the preoperative platelet to lymphocyte ratio (PLR) is predictive of survival of women with ovarian clear cell carcinoma (OCCC)
The treatment guidelines for OCCC are similar to those currently utilized for other types of EOC, including initial surgery for staging and cyto-reduction followed by adjuvant paclitaxel and carboplatin chemotherapy
Summary
Ovarian clear cell carcinoma (OCCC) is characterized by clear cells growing in a solid/tubular or glandular pattern, as well as hobnail cells (Tavassoli and Deville, 2003). Despite significant advances in surgery and chemotherapy achieved over recent decades, OCCC portends poorer survival after adjusting for age, histology grade, and stage of disease over against other types of EOC.( Pectasides et al, 2006; Chan, et al, 2008; Sirichaisutdhikorn et al, 2009) The current study, explored the detailed pathology characteristics and prognostic factors linked to clinical outcomes; of potential interest in the search for new therapeutic strategies for OCCC. The preoperative platelet to lymphocyte ratio (PLR)-a novel and valuable platelet index-is known to be associated with survival outcomes of various cancers including gynecologic ones (Smith, et al, 2009; Asher et al, 2011; Raungkaewmanee, et al, 2012; Ertas, et al, 2013; Liu, et al, 2013; Rassouli, et al, 2013; Unal, et al, 2013; Wang, et al, 2013). The present study was designed (a) to determine the association of preoperative PLR on the treatment outcomes (including stage, residual lesion after operation, response rate, and detailed pathology characteristics); (b) to test the correlation of PLR with survival
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