Abstract
Background: Recent studies have demonstrated that the tumor microenvironment, known to be influenced by inflammatory cells, plays a crucial role in cancer progression and clinical outcome of patients. The objective of the present study was to investigate prognostic values of preoperative neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) for disease-free survival (DFS) and overall survival (OS) of uterine sarcoma patients. Methods: Ninety-nine patients with uterine sarcoma treated in eight multicenter institutions over the last 20 years were retrospectively analyzed. Curves of DFS and OS were calculated using the Kaplan–Meier method, and univariate and multivariate analyses of various prognostic factors were performed using a Cox proportional hazard regression model. Results: High NLR was significantly associated with worse DFS (p = 0.007) and OS (p = 0.039). Advanced stage (p = 0.017) and high mitotic index (p = 0.036) retained their prognostic significance for DFS. Other clinical variables, including PLR, CA125, and lactate dehydrogenase (LDH) failed to show significant impact. Conclusions: Our findings showed that an elevated preoperative NLR was associated with poor clinical outcome in uterine sarcoma patients. Our results suggest that high NLR in early-stage uterine sarcoma patients might indicate that such patients need more intensive treatments.
Highlights
Uterine sarcoma is a rare gynecologic tumor, accounting for 1–3% of all female genital tract malignancies
Few studies have suggested that serum CA-125 and lactate dehydrogenase (LDH) levels might be helpful for preoperative diagnosis and surveillance of uterine sarcomas
The study population was stratified into normal body weight (BMI: 18.5–22.9 kg/m2) and overweight or obese (BMI ≥ 23 kg/m2) according to body mass index (BMI) categories suggested by the World Health Organization for the Asian population
Summary
Uterine sarcoma is a rare gynecologic tumor, accounting for 1–3% of all female genital tract malignancies. Few studies have suggested that serum CA-125 and lactate dehydrogenase (LDH) levels might be helpful for preoperative diagnosis and surveillance of uterine sarcomas. Their efficacy remains controversial [4,5]. The objective of the present study was to investigate prognostic values of preoperative neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) for disease-free survival (DFS) and overall survival (OS) of uterine sarcoma patients. Conclusions: Our findings showed that an elevated preoperative NLR was associated with poor clinical outcome in uterine sarcoma patients. Our results suggest that high NLR in early-stage uterine sarcoma patients might indicate that such patients need more intensive treatments
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