Verification of Pre-treatment NLR and PLR on the Prognosis of Patients with Locally Advanced Cervical Cancer

Abstract

Previous studies showed that neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were important prognostic factors for patients with cervical cancer. The purpose of this study was to verify the correlation between pre-treatment NLR, PLR and clinical outcomes in patients with locally advanced cervical cancer. We reviewed 222 cervical cancer patients who underwent definitive concurrent chemoradiotherapy or radiotherapy in 2014 in our institute. The patients were divided into different groups based on the optimal cut-off values of pre-treatment NLR or PLR according to receiver operating characteristic curves. The survival outcomes were calculated with Kaplan-Meier method. Cox proportional hazard model were used for univariate and multivariate analyses. The median follow-up duration was 34 months (range,3-66months). For the whole group, 3-year OS, DFS, LC were 83%, 80%, 91%, respectively. NLR = 1.8 and PLR = 151 were selected as the best cut-off values, respectively. The 3-year OS, DFS and LC in the high NLR group were 82%, 79% and 88%, while the 3-year OS, DFS and LC in the low NLR group were 86%, 85% and 96%, respectively, and the differences were not statistically significant. The 3-year OS, DFS and LC in the high PLR group were 88%, 80% and 91%, while the 3-year OS, DFS and LC in the low PLR group were 79%, 80% and 90%, respectively, and there were also no statistically significant differences between both groups. Univariate analysis showed that FIGO stage, overall treatment time, total dose of brachytherapy, and cycles of concurrent chemotherapy were important prognostic factors for OS of locally advanced cervical cancer. Overall treatment time was significantly corelated with DFS and LC of locally advanced cervical cancer. Multivariate analysis indicated that overall treatment time and total dose of brachytherapy were independent prognostic factors for locally advanced cervical cancer, respectively. There are no significant correlation between pre-treatment NLR or PLR and the survival outcomes of locally advanced cervical cancer in the present study. Further trials will be required to validate whether pre-treatment NLR and PLR are important prognostic factors for locally advanced cervical cancer.