Pre-treatment neutrophil to lymphocyte ratio and platelet to lymphocyte ratio as potential prognostic factors in patients with newly diagnosed ovarian cancer.

Abstract

e16555 Background: Recent studies have shown that the presence of systemic inflammation correlates with worse outcomes in many types of cancers. The neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) have been proposed as indicators of systemic inflammatory response. The aim of the study was to assess the prognostic value of pre-treatment NLR and PLR in patients with newly diagnosed ovarian cancer. Methods: We conducted a retrospective analysis of medical documentation of 172 patients with newly diagnosed ovarian cancer, treated in Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch between 2008 and 2012. ROC curves for PFS, EFS and OS prediction were plotted to verify cut-off points for NLR and PLR. Progression free survival (PFS), event free survival (EFS), and overall survival (OS) were analysed for correlation with NLR and PLR using Cox regression model. Results: Patients with pre-treatment NLR as well as PLR greater than or equal to the cut-off point determined by ROC curve analysis achieved significantly shorter PFS (p = 0.0007 and p < 0.0001 respectively), EFS (both, p < 0.0001) and OS (both, p < 0.0001) in comparison to patients with NLR and PLR below the cut-off point. Higher pre-treatment NLR and PLR were associated with worse performance status, higher Ca-125 level and advanced stage of the disease (all, p < 0.0001). In univariate analysis pre-treatment NLR and PLR were negative prognostic factors for PFS (p = 0.0003 and p < 0.0001 respectively), EFS (both, p < 0.0001) and OS (both, p < 0.0001). However, in multivariate analysis independent prognostic factor for PFS were only: clinical stage (p = 0.0001), Ca-125 level (p = 0.0479) and PLR (p = 0.0447). The only independent prognostic factor for EFS was clinical stage (p < 0.0001). Conclusions: Patients with elevated NLR and PLR had significantly worse survival outcomes. In univariate analysis both, NLR and PLR were associated with poor prognosis. However, in multivariate analysis only PLR remained independent prognostic factor (for PFS).