Leukocyte and platelet counts as prognostic values of testicular germ cell tumors

Abstract

IntroductionThe immune system plays an essential role in the organism's response to cancer. Several hematological markers can influence prognosis and survival of patients. The objective of this study is to determine their prognostic value in testicular germ cell tumors. Material and methodsRetrospective cohort study on 164 patients with germ cell tumors. Clinical, analytical, histological and evolutionary data were collected. The absolute neutrophil and absolute platelet counts, neutrophil–lymphocyte (NLR), platelet–lymphocyte and lymphocyte–monocyte ratios were estimated at diagnosis. The association that these markers can have with the classic prognostic factors, as well as their effect on prognosis and survival, have been analyzed. Results17.7% had NLR >4 and 14.6% ANC >8000/μL. These patients presented higher percentages of residual disease and stage II–III tumors. Patients with elevated absolute neutrophil showed also higher percentages of progression and exitus.7.3% presented absolute platelet >400,000/μL. These patients obtained higher rates of residual disease, nonseminomatous and stage III tumors. 28.4% showed platelet–lymphocyte values >150. This data was associated to higher percentages of residual disease, progression, stage II and III tumors and seminomatous tumors.83.3% had a lymphocyte–monocyte >3. These patients presented: higher tumor markers in normal range, decreased residual disease rates and higher percentages of stage I and II tumors.The mean survival time was shorter in patients with NLR >4 and absolute neutrophil >8000/μL.The ROC curves showed significance in the prediction of progression and values of lymphocyte–monocyte >3, and prediction of survival and values NLR >4. ConclusionOur results indicate that the analyzed hematological markers are associated with poor prognoses at diagnosis. Therefore, their use in daily clinical practice can be a valuable tool in the diagnosis and prognosis of patients with testicular germ cell tumors.