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      Prognostic Significance of Retroperitoneal Lymphadenectomy, Preoperative Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio in Primary Fallopian Tube Carcinoma: A Multicenter Study

      research-article
      Author(s): , MD 1 , , MD 1 , , MD 1 , , MD 1 , , MD 2 , , MD 3 , , MD 1 , , MD 4 , , MD 2 , , MD 5 , , MD 6 , , MD 1 , , MD 1 , , MD 5 , , MD 1 , , MD 5 , , MD 6 , , MD 4 , , MD 2 , , MD 2 , , MD 1 , , MD 3
      Publication date (Electronic):
      Journal: Cancer Research and Treatment : Official Journal of Korean Cancer Association
      Publisher: Korean Cancer Association
      Keywords: Primary fallopian tube carcinoma, Retroperitoneal lymphadenectomy, Neutrophil lymphocyte ratio, Platelet lymphocyte ratio, Prognostic factor

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          Abstract

          Purpose

          The purpose of this study is to evaluate the prognostic role of preoperative neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) and the need for para-aortic lymphadectomy in patients with primary fallopian tube carcinoma (PFTC).

          Materials and Methods

          Ninety-one patients with a diagnosis of PFTC were identified through the gynecologic oncology service database of six academic centers. Clinicopathological, surgical, and complete blood count data were collected.

          Results

          In univariate analysis, advanced stage, suboptimal surgery, and NLR > 2.7 were significant prognostic factors for progression-free survival, whereas in multivariate analysis, only advanced stage and suboptimal surgery were significant. In addition, in univariate analysis, cancer antigen 125 ≥ 35 U/mL, ascites, advanced stage, suboptimal surgery, NLR > 2.7, PLR > 233.3, platelet count ≥ 400,000 cells/mm 3, staging type, and histological subtype were significant prognostic factors for overall survival (OS); however, in multivariate analysis, only advanced stage, suboptimal surgery, NLR > 2.7, and staging type were significant. Inclusion of pelvic and para-aortic lymphadenectomy in surgery showed significant association with longer OS, with a mean and median OS of 42.0 months and 35.5 months (range, 22 to 78 months), respectively, vs. 33.5 months and 27.5 months (range, 14 to 76 months), respectively, for patients who underwent surgery without para-aortic lymphadenectomy (hazard ratio, 3.1; 95% confidence interval, 1.4 to 5.7; p=0.002).

          Conclusion

          NLR (in both univariate and multivariate analysis) and PLR (only in univariate analysis) were prognostic factors in PFTC. NLR and PLR are inexpensive and easy tests to perform. In addition, patients with PFTC who underwent bilateral pelvic and para-aortic lymphadenectomy had longer OS.

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          A comparison of inflammation-based prognostic scores in patients with cancer. A Glasgow Inflammation Outcome Study.

          Michael Proctor, David Morrison, Dinesh Talwar … (2011)
          Components of the systemic inflammatory response, combined to form inflammation-based prognostic scores (modified Glasgow Prognostic Score (mGPS), Neutrophil Lymphocyte Ratio (NLR), Platelet Lymphocyte Ratio (PLR), Prognostic Index (PI), Prognostic Nutritional Index (PNI)) have been associated with cancer specific survival. The aim of the present study was to compare the prognostic value of these scores. Patients (n=27,031) who had an incidental blood sample taken between 2000 and 2007 for C-reactive protein, albumin, white cell, neutrophil, lymphocyte and platelet counts, as well as a diagnosis of cancer (Scottish Cancer Registry) were identified. Of this group 8759 patients who had been sampled within two years following their cancer diagnosis were studied. On follow up, there were 5163 deaths of which 4417 (86%) were cancer deaths. The median time from blood sampling to diagnosis was 1.7 months. An elevated mGPS, NLR, PLR, PI and PNI were predictive of a reduced cancer specific survival independent of age, sex and deprivation and tumour site (all p<0.001). The area under the receiver operator curves was greatest for mGPS and PI. Specifically, in colorectal cancer, an elevated mGPS and PI were predictive of a reduced cancer specific survival independent of age, sex, deprivation and tumour stage (both p<0.001). The results of the present study show that systemic inflammation-based scores, in particular the mGPS and PI, have prognostic value in cancer independent of tumour site. Based on the present results and the existing validation literature, the mGPS should be included in the routine assessment of all patients with cancer. Copyright © 2011 Elsevier Ltd. All rights reserved.
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            Preoperative platelet lymphocyte ratio as an independent prognostic marker in ovarian cancer.

            Anish Bali, Joanne Lee, Anni Innamaa … (2011)
            Ovarian cancer is associated with high mortality due to presentation at advanced stage and high recurrence following treatment with chemotherapy. Most of the prognostic variables in ovarian cancer, including stage and residual disease, are amenable for assessment only after surgery. Currently there are no established preoperative markers including, CA-125, that can predict overall survival in patients with ovarian cancer. The aim of our study was to evaluate the prognostic significance of the preoperative haematological markers platelet lymphocyte ratio (PLR) and neutrophil lymphocyte ratio (NLR) in patients with ovarian cancer. Preoperative PLR and NLR were evaluated in 235 patients undergoing surgery for ovarian cancer. The prognostic significance of both markers was then determined by both uni- and multivariate analytical methods. High preoperative PLR (p 300. PLR (p = 0.03) but not NLR (p = 0.575) retained its significance as a prognostic marker on multivariate Cox's regression analysis, along with stage (p < 0.001) and residual disease (p = 0.015). We have shown for the first time that PLR is a novel independent prognostic marker in patients with ovarian cancer.
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              Pretreatment neutrophil:lymphocyte ratio as a prognostic factor in cervical carcinoma.

              Hai-Joong Kim, Sang Lee, Jang Won Lee … (2012)
              This study was designed to investigate the prognostic value of the neutrophil:lymphocyte ratio (NLR) in cervical cancer. Patients with clinically staged cervical carcinoma (IB to IVA) at Samsung Medical Center, Seoul, Korea, from 1996 to 2007 were retrospectively enrolled. We enrolled 1061 patients with cervical cancer. The median NLR was 1.9, with a range of 0.3-27.0. When the cohort was divided according to the median NLR, poorer survival outcomes were observed in the group with higher NLR (≥1.9) than in the lower NLR group (<1.9). Patients of the higher NLR group (≥1.9) were younger in age and had more advanced staged disease when compared with those of the lower NLR group (<1.9). In multivariable analysis, higher pretreatment NLR was identified as being an independent poor prognostic factor for survival. Pretreatment NLR may be a cost-effective biomarker to stratify risk of recurrence and death in patients with cervical cancer.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Cancer Res Treat
                Journal ID (iso-abbrev): Cancer Res Treat
                Journal ID (publisher-id): CRT
                Title: Cancer Research and Treatment : Official Journal of Korean Cancer Association
                Publisher: Korean Cancer Association
                ISSN (Print): 1598-2998
                ISSN (Electronic): 2005-9256
                Publication date (Print): July 2015
                Publication date (Electronic): 17 November 2014
                Volume: 47
                Issue: 3
                Pages: 480-488
                Affiliations
                [1 ]Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey
                [2 ]Department of Gynecologic Oncology, Osmangazi University School of Medicine, Eskisehir, Turkey
                [3 ]Department of Gynecologic Oncology, Ankara University School of Medicine, Ankara, Turkey
                [4 ]Department of Gynecologic Oncology, Cukurova University School of Medicine, Adana, Turkey
                [5 ]Department of Gynecologic Oncology, Ege University School of Medicine, Izmir, Turkey
                [6 ]Department of Gynecologic Oncology, Akdeniz University School of Medicine, Antalya, Turkey
                Author notes
                Correspondence: Aykut Ozdemir, MD Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Gaziler Street, No: 468, 35120 Izmir, Turkey Tel: 90-505-270-3550 Fax: 90-232-433-5008 E-mail: isaaykutozdemir@ 123456hotmail.com
                Article
                Publisher ID: crt-2014-058
                DOI: 10.4143/crt.2014.058
                PMC ID: 4506112
                PubMed ID: 25622588
                SO-VID: 7a235b73-7c8e-4145-aba9-b4603381a96e
                Copyright © Copyright © 2015 by the Korean Cancer Association
                License:

                This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 6 March 2014
                Date accepted : 1 May 2014
                Categories
                Subject: Original Article

                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: primary fallopian tube carcinoma,retroperitoneal lymphadenectomy,neutrophil lymphocyte ratio,platelet lymphocyte ratio,prognostic factor
                Data availability:
                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: primary fallopian tube carcinoma, retroperitoneal lymphadenectomy, neutrophil lymphocyte ratio, platelet lymphocyte ratio, prognostic factor

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