scholarly journals Pretreatment Neutrophil-to-Lymphocyte Ratio Combined with Platelet-to-Lymphocyte Ratio as a Predictor of Survival Outcomes after Definitive Concurrent Chemoradiotherapy for Cervical Cancer

2021 ◽  
Vol 10 (10) ◽  
pp. 2199
Author(s):  
Jeong Won Lee ◽  
Ki Ho Seol
Keyword(s):  
Cervical Cancer ◽  
Overall Survival ◽  
Clinical Outcomes ◽  
Concurrent Chemoradiotherapy ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Neutrophil To Lymphocyte Ratio ◽  
Survival Outcomes ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio

The aim of the study was to evaluate pretreatment neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as prognostic factors for predicting clinical outcomes after definitive concurrent chemoradiotherapy (CCRT) for cervical cancer. The cases were divided into two groups based on the values of NLR and PLR: High NLR-PLR (high value in both NLR and PLR) and Low NLR-PLR (low value in either NLR or PLR). The relationships between survival outcomes and the pretreatment NLR-PLR were investigated. Of the 148 patients enrolled in the study, 30 patients died during the median follow-up of 75 months. Based on receiver operating curves, NLR and PLR cut-off values for survival analysis were 2.34 and 148.89. The 10-year overall survival and disease-free survival rates for high NLR-PLR vs. low NLR-PLR were 63.6% vs. 86.2% (p = 0.001) and 63.3% vs. 77.5% (p = 0.026), respectively. Based on a multivariate analysis, independent predictors of overall survival were high NLR-PLR (hazard ratio [HR], 2.435; 95% confidence interval [CI], 1.106–5.361; p = 0.027) and stage (HR 2.659; 95% CI, 1.146–6.613; p = 0.024). Increases in both NLR and PLR are associated with poor survival. Elevation in both NLR and PLR before initiation of CCRT may be a useful biomarker for predicting clinical outcomes.

Establishing the prognostic value of platelet-to-lymphocyte ratio in cervical cancer: a systematic review and meta-analysis

2019 ◽  
Vol 29 (4) ◽  
pp. 683-690 ◽  
Author(s):  
Lixiao Yang ◽  
Huixiao Chen
Keyword(s):  
Cervical Cancer ◽  
Overall Survival ◽  
Prognostic Value ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Survival Outcomes ◽  
Platelet To Lymphocyte Ratio ◽  
Free Survival ◽  
Lymphocyte Ratio ◽  
Meta Regression

ObjectiveThe aim of this study was to conduct a meta-analysis to establish the prognostic value of platelet-to-lymphocyte ratio in cervical cancer.MethodsWe conducted a search in Medline and Embase datasets for articles published until May 1, 2018 to perform a meta-analysis to establish the prognostic value of platelet-to-lymphocyte ratio in cervical cancer. The primary survival outcomes were overall survival and progression-free survival. The pooled hazard ratios (HRs) and 95% confidence intervals (95% CIs) were combined to calculate overall effects. Cochran’s Q test and Higgins’ I2statistics were employed to estimate the heterogeneity. In addition, the subgroup analysis, sensitivity analysis, and meta-regression were performed to identify the source of heterogeneity. Egger’s linear regression test and Begg’s funnel plot and the trim and fill methods were employed to evaluate the publication bias.ResultsA total of 2616 patients from eight studies were enrolled in the meta-analysis. Significant association was observed between elevated platelet-to-lymphocyte ratio and a worse overall survival, with a combined HR of 1.49 (95% CI 1.24 to 1.79, I2=32.8%). Elevated platelet-to-lymphocyte ratio was significantly associated with a worse progression-free survival, with a combined HR of 1.65 (95% CI 1.17 to 2.33, I2= 49.4%). Subsequently, sensitivity analysis, subgroup analysis, and meta-regression model containing six predominant factors were applied to trace the origin of heterogeneity. However, no significant factors or studies were explored as the potential source of heterogeneity.ConclusionElevated pre-treatment platelet-to-lymphocyte ratio may be an adverse prognostic factor for overall survival and progression-free survival in patients with cervical cancer. Further investigations are warranted to determine the exact mechanism by which platelet-to-lymphocyte ratio impacts survival outcomes in cervical cancer.

scholarly journals Does Preoperative Serum Neutrophil To Lymphocyte Ratio (NLR), Platelet To Lymphocyte Ratio (PLR) And Lymphocyte To Monocyte Ratio (LMR) Predict Prognosis Following Radical Surgery For Pancreatic Adenocarcinomas? - Results of A Retrospective Study.

2021 ◽  
Author(s):  
Vikas Bachelal Gupta ◽  
Vikram Chaudhari ◽  
Shailesh V. Shrikhande ◽  
Manish S. Bhandare
Keyword(s):  
Overall Survival ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Tnm Stage ◽  
Neutrophil To Lymphocyte Ratio ◽  
Survival Outcomes ◽  
P Value ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Lymphocyte To Monocyte Ratio

Abstract Background:Pretherapy serum neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and lymphocyte to monocyte ratio (LMR) have been shown to predict prognosis in patients with pancreatic ductal adenocarcinoma (PDAC). However, the published literature is conflicting, hence we aimed to evaluate their role in predicting survival outcomes in operated patients of PDAC.Methods: A retrospective analysis was done of all operated cases of PDAC who underwent curative resection between 2011 to 2018. The pretherapy NLR, PLR and LMR were calculated and analyzed with respect to pathological and survival outcomes Results:134 operated patients were included. The median overall survival for NLR of less than 2, 2.7 and 5 was 30.8, 27.2 and 27.5 months and for NLR more than 2, 2.7 and 5 was 22.9, 21.6 and 21.5 months respectively and was statistically insignificant (p-value- 0.32, 0.91, 0.34 respectively). Similarly, the PLR was not significant for a cut off of 150 (p-value- 0.27) and LMR was not significant for a cut off of 2.8 (p-value- 0.13) and 4.8( p-value -0.11). On Univariate analysis age, CA 19-9, perineural invasion, margin positivity, lymph node positivity and TNM stage were found to have significant correlation with overall survival. However, on multivariate analysis, only TNM stage was found to be significant. Conclusion:The NLR, PLR and LMR do not correlate with overall survival in operated patients with PDAC in this study. A combination of inflammatory markers or their dynamic testing might probably achieve prognostic significance.

Burden of lymphatic disease predicts efficacy of adjuvant radiation and chemotherapy in FIGO 2018 stage IIICp cervical cancer

2019 ◽  
Vol 29 (9) ◽  
pp. 1355-1360 ◽  
Author(s):  
Giorgio Bogani ◽  
Daniele Vinti ◽  
Ferdinando Murgia ◽  
Valentina Chiappa ◽  
Umberto Leone Roberti Maggiore ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Overall Survival ◽  
Disease Free Survival ◽  
Rank Test ◽  
Survival Outcomes ◽  
Adjuvant Radiation ◽  
Free Survival ◽  
Log Rank Test ◽  
Disease Free ◽  
Positive Lymph Nodes

ObjectiveNodal involvement is one of the most important prognostic factors in cervical cancer patients. We aimed to assess the prognostic role in relation to the burden of nodal disease in stage IIICp cervical cancer.MethodsData on all consecutive patients diagnosed with cervical cancer undergoing primary surgery (radical hysterectomy plus lymphadenectomy) or neoadjuvant chemotherapy followed by radical hysterectomy plus lymphadenectomy, between January 1980 and December 2017, were collected in a dedicated database. Exclusion criteria were: (1) consent withdrawal; (2) synchronous malignancies (within 5 years). Survival outcomes were assessed using Kaplan-Meier and Cox models.ResultsOverall, 177 (14.1%) of 1257 patients with cervical cancer were diagnosed with positive lymph nodes. After a median follow-up of 58 (range 4–175) months, 66 (37.3%) and 37 (20.9%) patients developed recurrent disease and died of disease, respectively. Via multivariate analysis, positive para-aortic nodes (HR 2.62, 95% CI 1.12 to 6.11; p=0.025) and the number of positive nodes (HR 1.06, 95% CI 1.02 to 1.11; p=0.002) correlated with worse disease-free survival. Furthermore, the number of positive nodes (HR 1.06, 95% CI 1.01 to 1.12; p=0.021) correlated with worse overall survival. Number of positive nodes (1, 2 or ≥3) strongly correlated with both disease-free survival (p<0.001, log-rank test) and overall survival (p=0.001, log-rank test). Focusing on patients receiving adjuvant radiation and chemotherapy, the number of positive lymph nodes was associated with response to treatment (p<0.001). Median disease-free survival was 100, 42, and 12 months for patients with one, two, or three or more positive lymph node(s), respectively (p<0.001, log-rank test).ConclusionsIn stage IIICp cervical cancer, adjuvant radiation and chemotherapy provides adequate overall survival in patients diagnosed with only one metastatic node, while survival outcomes are poor in patients with two or more metastatic nodes. This highlights the need for innovative treatments in patients with a high burden of lymphatic disease.

The prognostic value of systemic inflammatory factors in patient with metastatic gastric cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15505-e15505 ◽  
Author(s):  
Georgy M. Manikhas ◽  
Natalia P. Beliak ◽  
Svetlana I. Kutukova ◽  
Natalia V. Zhukova ◽  
Natalia V. Popova ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Inflammatory Markers ◽  
Prognostic Biomarker ◽  
Metastatic Gastric Cancer ◽  
Neutrophil To Lymphocyte Ratio ◽  
C Reactive Protein ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Reactive Protein

e15505 Background: Inflammation seems to be significant factor in carcinogenesis and tumor progression of numerous cancers. Blood calculated neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein (CRP), lactate dehydrogenase (LDH), international normalized ratio (INR) can be evaluated as systemic inflammation markers and prognostic biomarker for many aims: survival outcomes, lymph node metastasis and recurrence, treatment responses in a variety of cancers. The purpose of this study was to investigate baseline associations between blood test parameters (NLR, PLR, LDH, CRP, INR) and their prognostic biomarker role for patient with metastatic gastric cancer, undergoing first-line chemotherapy Methods: Potential baseline inflammatory markers (platelets, neutrophils, lymphocytes, the platelet-lymphocyte ratio, the neutrophil-lymphocyte ratio, the serum C-reactive protein [CRP], the serum LDH, INR) were retrospectively analyzed in 32 patients with metastatic gastric cancer, IV stage (median of age – 60,50). Multivariate analyses were used to identify prognostic factors for overall survival (OS). Baseline values were compared with tumor characteristic and median survival times (MSTs). Results: Multivariate analysis identified due to Cox proportional-hazards regression showed significant longest OS in patients with: localization of primary tumor in antral part of gastric (HR 0,45, 95% CI 0,25-0,80, p = 0,0065); low baseline’s level of WBC (HR 1,17, 95% CI 1.02 - 1,35, p = 0,0219); low baseline’s level of neutrophil (HR 1,18, 95% CI 1.02 - 1,34, p = 0,0251). Level of LDH, CRP, INR didn’t show significant ratio for this cohort of patient. Peritoneum metastatic also didn’t significant affect on OS in patient with metastatic gastric cancer. Patients with low baseline’s platelet to lymphocyte ratio (HR 1,004, 95% CI 1,0009-1,0072, p = 0,0125) and low (from 0 to 3,0) neutrophil to lymphocyte ratio (HR 1,81, 95% CI 1,09-2,99, p = 0,0212) had a significantly longest OS time. Conclusions: Inflammatory markers can predict overall survival in stage IV gastric cancer. Simple and useful.

scholarly journals Neutrophil-to-lymphocyte ratio has limited predictive value for determining outcomes in perforated colon cancer: a propensity score analysis.

2020 ◽  
Author(s):  
Chunyi Wu ◽  
Jy-Ming Chiang ◽  
Jeng-Fu You ◽  
Reiping Tang ◽  
Jinn-Shiun Chen ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Overall Survival ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Disease Free Survival ◽  
Neutrophil To Lymphocyte Ratio ◽  
Free Survival ◽  
Lymphocyte Ratio ◽  
Disease Free ◽  
Perforated Colon

Abstract Background: The neutrophil-to-lymphocyte ratio is a significant prognostic marker in resectable colorectal cancer; however, there are no equivalent findings for perforated colon cancer. Using our colorectal cancer database, we retrospectively analyzed the data from 1995 to 2015 to determine whether the preoperative neutrophil-to-lymphocyte ratio is associated with survival outcomes in patients with perforated colon cancer.Methods: One-to-one propensity score matching was applied to minimize the difference between the high (>5) and low (≤5) neutrophil-to-lymphocyte ratio groups. Clinicopathological factors, long-term overall survival, and disease-free survival were analyzed and compared between the two groups. The primary outcomes were overall survival and disease-free survival.Results: Before propensity score matching, the high neutrophil-to-lymphocyte ratio group had a significantly higher prevalence of leukocytosis (low vs. high neutrophil-to-lymphocyte ratio groups: 12 [12.9%] vs. 46 [59.7%], p<0.001), lower serum albumin levels (low vs. high neutrophil-to-lymphocyte ratio groups: 30 [32.3%] vs. 42 [54.5%], p=0.003), and a higher emergent operation rate (low vs. high neutrophil-to-lymphocyte ratio groups: 5 [5.4%] vs. 20 [26.0%], p<0.001). After one-to-one propensity score matching, the groups comprised 41 patients each; none of the parameters were significantly different between the two groups. The mean follow-up period was 76.3 months. The 5-year overall survival (p=0.637) and disease-free survival (p=0.827) rates were not significantly different between the high and low neutrophil-to-lymphocyte ratio groups.Conclusions: The neutrophil-to-lymphocyte ratio has limited predictive value for determining outcomes in patients with perforated colon cancer.

scholarly journals Comparison of Chemoradiotherapy and Radical Radiotherapy in Patients With Cervical Cancer

2020 ◽  
pp. 15-20
Author(s):  
Ozlem Yetmen Dogan ◽  
Ismet Sahinler
Keyword(s):  
Cervical Cancer ◽  
Overall Survival ◽  
Survival Rate ◽  
Treatment Failure ◽  
Locally Advanced ◽  
Survival Rates ◽  
Disease Free Survival ◽  
High Response Rate ◽  
Intracavitary Brachytherapy ◽  
Radical Radiotherapy

Introduction: The current study aimed at comparing the results of radical radiotherapy (RT) or chemoradiotherapy (CRT) in patients with cervical cancer and evaluating the prognostic factors. Methods: CRT is the standard of care for locally advanced cervical cancer with the five-year survival rate of 30%–80%. In 1978-2006, a total of 716 patients with cervical cancer stage IB2-IVB were retrospectively analyzed for RT and CRT. In intracavitary brachytherapy, the median dose was 24 Gy and follow-up was 78 months. CRT was treated with 45 Gy external radiotherapy with cisplatin 40 mg/m2 given once a week. Results: The five-year pelvic control rate was 56.2% in the radical RT arm and 75.8% in the combined arm (P=0.01); disease-free survival and overall survival rates were 47%-56.3% (P=0.09) and 44.9%-52.5% (P=0.03), respectively. Treatment failure was detected in 317(50.5%) of 627 patients in the RT arm and in 30 (33.7%) of 89 patients in the CRT arm (Chi-squared value=8.86, P<0.01). Treatment failure rate was high in the 1st two years. Distant metastases were detected in 116 patients in the RT and 17 patients in the CRT arms. Hematological side effect rates in the CRT arm -anemia, thrombopenia, and leukopenia- were 33.7%, 13.5%, and 28.1%, respectively. The prevalence of rectitis, cystitis, and skin and subcutaneous fibrosis in the RT arm was 9.4%, 4.8%, and 2.2%, and in the CRT arm was 12.4%, 11.2%, and 13.5%, respectively. Conclusions: CRT increased pelvic control and overall survival rate based on the findings; it can be the preferred treatment modality because of its high response rate and acceptable toxicity.

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