Abstract
BackgroundInflammation is pathognomonic of all stages of tumor formation, and therefore, there is renewed interest in systemic inflammatory response (SIR) markers including haematological inflammatory markers such as neutrophil-to-lymphocyte ratio (NLR) as prognostic predictors in several cancers.AimThis study was aimed to investigate the effect of pretreatment peripheral blood NLR on the survival prognosis of patients with epithelial ovarian cancer (EOC).MethodsWe identified 93 patients with a complete clinical record from a cohort of 155 patients who received treatment for EOC between 2009 and 2018. Patients’ sociodemographic and clinicopathologic characteristics, and updated three-year follow-up status were extracted from medical records. Pretreatment peripheral blood NLR was calculated by dividing the neutrophil count by the lymphocyte count. We employed the receiver operating characteristic (ROC) curve to identify the optimal cut-off value of the NLR in estimating progression-free survival (PFS) and overall survival (OS). The PFS and OS were assessed using the Kaplan-Meier method, and survival differences were compared using the Log Rank (Mantel-Cox) test. Independent prognostic predictors were determined using Cox regression analysis.ResultsAccording to the ROC curves, the optimal cut-off values for the NLR were 2.23 and 1.93 for PFS and OS, respectively. A high NLR was associated with poor PFS (P = 0.033) and OS (P = 0.013) in the univariate analyses. In the multivariate analyses, a high NLR was still an independent predictor of OS (hazard ratio [HR] = 2.23; 95% CI, 1.08 to 4.61) but not PFS (hazard ratio [HR] = 2.43; 95% CI, 0.95 to 6.27).ConclusionThe NLR at an optimum cut-off value of 1.93 is an independent prognostic predictor of OS in patients with EOC.
Highlights
About 90% of all histological types of ovarian cancer are of epithelial origin [1,2] with over 70% of epithelial ovarian cancer (EOC) being diagnosed at the advanced stage of the disease [3]
A high neutrophil-to-lymphocyte ratio (NLR) was still an independent predictor of overall survival (OS) but not progression-free survival (PFS)
In corroboration with the findings of other published studies [27,28] suggesting that the NLR is an independent prognostic predictor of survival, our study found that the different survival endpoints have different cut-off values and that the NLR has a significant prognostic value in EOC patients
Summary
About 90% of all histological types of ovarian cancer are of epithelial origin [1,2] with over 70% of epithelial ovarian cancer (EOC) being diagnosed at the advanced stage of the disease [3]. Inflammation is seen in all stages of tumor formation including the initiation, promotion, progression, invasion, and metastasis of a tumor [9,10], and there is currently a renewed interest in systemic inflammatory response (SIR) markers including. One of such hematological inflammatory markers that have shown the potential to be a credible prognostic marker in various cancers including EOC is the neutrophil-tolymphocyte ratio (NLR) [11,12,13,14]. Inflammation is pathognomonic of all stages of tumor formation, and there is renewed interest in systemic inflammatory response (SIR) markers including haematological inflammatory markers such as neutrophil-to-lymphocyte ratio (NLR) as prognostic predictors in several cancers
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
