Prognostic role of platelet lymphocyte ratio in advanced epithelial ovarian cancer
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20243580Keywords:
Advanced epithelial ovarian cancer, Biomarker, Platelet-lymphocyte ratio, Prognosis, SurvivalAbstract
Background: The platelet lymphocyte ratio (PLR) is an important prognostic biomarker in various cancers. Study was undertaken to determine the association between PLR and prognosis of advanced epithelial ovarian cancer.
Methods: The prospective observational study was carried out gynecological oncology unit, department of gynecology and obstetrics Dhaka Medical College Hospital. Dhaka. Total 50 cases of diagnosed advanced epithelial ovarian cancer where enrolled during period from January 2021 to December 2021.
Results: The mean age of participants was 52.8±11.5 years, with 68.0% being postmenopausal and 94.0% multigravida. Tumor grade III was most prevalent (58.0%), and the majority (62.0%) had serous carcinoma. Pre-operative CA-125 levels were <1000 in 72.0% of patients. The platelet-lymphocyte ratio (PLR) was <200 in 58.0% of patients, with no significant association between PLR and chemotherapy response (p=0.121). Progression-free survival was observed in 30.0%, with an overall survival of 58.0%. A significant association was found between PLR and survival outcomes (p=0.013). ROC analysis indicated an area under the curve of 0.726, establishing a cutoff value of ≥171.5 ng/ml for PLR, with 86.2% sensitivity and 66.7% specificity for predicting overall survival.
Conclusions: This study suggested that the significant association was found between PLR with survival outcome. No significant association between PLR with before and after operation and chemotherapy.
Metrics
References
Yang J, Ma J, Cheng S, Wang Y. The combination of plasma fibrinogen concentration and neutrophil lymphocyte ratio (F-NLR) as a prognostic factor of epithelial ovarian cancer. Onco Targets and Ther. 2020;13:7283-93
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin. 2020;70(1):7-30.
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424.
Ozols RF, Bundy BN, Greer BE, Fowler JM, Clarke-Pearson D, Burger RA, et al. Phase III trial of carboplatin and paclitaxel compared with cisplatin and paclitaxel in patients with optimally resected stage III ovarian cancer: a Gynecologic Oncology Group study. J Clin Oncol. 2003;21(17):3194-200.
Chon S, Lee S, Jeong D, Lim S, Lee K, Shin J. Elevated platelet lymphocyte ratio is a poor prognostic factor in advanced epithelial ovarian cancer. J Gynecol Obstet Hum Reprod. 2020;S2468-7847(20):30193-8
Gadducci A, Cosio S, Tana R, Genazzani AR. Serum and tissue biomarkers as predictive and prognostic variables in epithelial ovarian cancer. Crit Rev Oncol Hematol. 2009;69(1):12-27.
Gupta D, Lis CG. Role of CA125 in predicting ovarian cancer survival- a review of the epidemiological literature. J Ovar Res. 2009;2:13.
Polat M, Senol T, Ozkaya E, Ogurlu Pakay G, Cikman MS, Konukcu B, et al. Neutrophil to lymphocyte and platelet to lymphocyte ratios increase in ovarian tumors in the presence of frank stromal invasion. Clin Transl Oncol. 2016;18:457-63.
Ishizuka M, Oyama Y, Abe A, Kubota K. Combination of platelet count and neutrophil to lymphocyte ratio is a useful predictor of postoperative survival in patients undergoing surgery for gastric cancer. J Surg Oncol. 2014;110:935-41.
Kasmann L, Bolm L, Schild SE, Janssen S, Rades D. Neutrophil-to-lymphocyte ratio predicts outcome in limited disease small-cell lung cancer. Lung. 2017;195:217-24.
Grivennikov SI, Greten FR, Karin M. Immunity, inflammation, and cancer. Cell. 2010;140(6):883-99.
Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature. 2008;454(7203):436-44.
Roxburgh CS, McMillan DC. Role of systemic inflammatory response in predicting survival in patients with primary operable cancer. Future Oncol. 2010;6(1):149-63.
Jain S, Harris J, Ware J. Platelets: linking hemostasis and cancer. Arterioscler Thromb Vasc Biol. 2010;30(12):2362-7.
Templeton AJ, Ace O, McNamara MG, Al-Mubarak M, Vera-Badillo FE, Hermanns T, et al. Prognostic role of platelet to lymphocyte ratio in solid tumors: a systematic review and meta-analysis. Cancer Epidemiol Biomark Prev. 2014;23(7):1204-12.
Zhou X, Du Y, Huang Z, Xu J, Qiu T, Wang J, et al. Prognostic value of PLR in various cancers: a meta-analysis. PLoS One. 2014;9(6):e101119.
Zhou M, Li L, Wang X, Wang C, Wang D. Neutrophil-to-lymphocyte ratio and platelet count predict long-term outcome of stage IIIC epithelial ovarian cancer. Cell Physiol Biochem. 2018;46(1):178-86.
Agameya AM, Labib K, Moiety F. Using platelet-to-lymphocyte ratio as a diagnostic marker in malignant ovarian tumors. Int J Reprod Contracept Obstet Gynecol. 2018;7:2089-92.
Badora-Rybicka A, Nowara E, Starzyczny-Słota D. Neutrophil-to lymphocyte ratio and platelet to- lymphocyte ratio before chemotherapy as potential prognostic factors in patients with newly diagnosed epithelial ovarian cancer. ESMO Open. 2016;1:e000039.
Raungkaewmanee S, Tangjitgamol S, Manusirivithaya S, Srijaipracharoen S, Thavaramara T. Platelet to lymphocyte ratio as a prognostic factor for epithelial ovarian cancer. J Gynecol Oncol. 2012;23(4):265-73.
Li Y, Li Y, Zhang J, Zheng C, Zhu H, Yu H, et al. Circulating insulin-like growth factor-1 level and ovarian cancer risk. Cell Physiol Biochem. 2016;38:589-97.
Tangjitgamol S, Manusirivithaya S, Laopaiboon M, Lumbiganon P, Bryant A. Interval debulking surgery for advanced epithelial ovarian cancer. Cochrane Database Syst Rev. 2010:D6014.
Vergote I, Trope CG, Amant F, Kristensen GB, Ehlen T, Johnson N, et al. Neoadjuvant chemotherapy or primary surgery in stage IIIC or IV ovarian cancer. N Engl J Med. 2010;363:943-53.
Rauh-Hain JA, Diver EJ, Clemmer JT, Bradford LS, Clark RM, Growdon WB, et al., Carcinosarcoma of the ovary compared to papillary serous ovarian carcinoma: a SEER analysis. Gynecol Oncol. 2013;131:46-51.