Obstet Gynecol Sci.  2017 Nov;60(6):558-564. 10.5468/ogs.2017.60.6.558.

Prognostic value of preoperative lymphocyte-monocyte ratio in elderly patients with advanced epithelial ovarian cancer

• Kwon BS
• Lee HJ
• Yang J
• Song YJ
• Suh DS
• Lee DH
• Kim KH

• KMID: 2418357
• DOI: http://doi.org/10.5468/ogs.2017.60.6.558

Abstract

OBJECTIVE
To investigate the prognostic significance of preoperative lymphocyte-monocyte ratio (LMR) in elderly patients with advanced epithelial ovarian cancer (EOC) receiving primary cytoreductive surgery and adjuvant platinum-based chemotherapy.
METHODS
A total of 42 elderly patients (≥65 years) diagnosed with EOC who are receiving primary cytoreductive surgery and adjuvant platinum-based chemotherapy from 2009 to 2012 was included. LMR was calculated from complete blood cell count sampled before operation. Receiver operating characteristic (ROC) curves were used to calculate optimal cut-off values for LMR. Prognostic significance with respect to overall survival (OS) and progression-free survival (PFS) were determined using log-rank test and Cox regression analysis.
RESULTS
The optimized LMR cut-off value determined by ROC curve analysis was 3.63 for PFS and OS. The high LMR group (LMR ≥3.63) was found to be significantly more associated with optimal debulking (P=0.045) and platinum response (P=0.018) than the low LMR group. In addition, Kaplan-Meier analysis revealed the LMR-high group was significantly more associated with high PFS and OS rates (P=0.023 and P=0.033, respectively), and univariate analysis revealed that a high LMR, histology type, and optimal debulking and platinum responses were significantly associated with prolonged PFS and OS. However, subsequent Cox multivariate analysis showed only optimal debulking and platinum response were independent prognostic factors of PFS or OS.
CONCLUSION
This study suggests that LMR might be associated with treatment and survival outcomes in elderly patients with EOC receiving standard oncology treatment.

Keyword

Aged; Ovarian epithelial cancer; Lymphocyte-monocyte ratio; Survival

MeSH Terms

Aged*
Blood Cell Count
Disease-Free Survival
Drug Therapy
Humans
Kaplan-Meier Estimate
Multivariate Analysis
Ovarian Neoplasms*
Platinum
ROC Curve
Platinum

Figure

• 

  Fig. 1 Receiver operating characteristic curve analyses showing cut-off points of lymphocyte-monocyte ratio for progression-free survival (PFS) and overall survival (OS) analyses among patients older than 65 years of age with advanced-stage serous epithelial ovarian cancer. The area under the curve for PFS was 0.696 (95% confidence interval [CI], 0.536 to 0.856; P=0.031) and for OS was 0.711 (95% CI, 0.555 to 0.868; P=0.025).

• 

  Fig. 2 Progression-free survival (PFS) and overall survival (OS) analysis according to the lymphocyte-monocyte ratio (LMR) in epithelial ovarian cancer.

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