Obstet Gynecol Sci.  2018 Mar;61(2):227-234. 10.5468/ogs.2018.61.2.227.

Pretreatment neutrophil-to-lymphocyte ratio and its dynamic change during neoadjuvant chemotherapy as poor prognostic factors in advanced ovarian cancer

• Kim YJ
• Lee I
• Chung YS
• Nam E
• Kim S
• Kim SW
• Kim YT
• Lee JY

• KMID: 2420176
• DOI: http://doi.org/10.5468/ogs.2018.61.2.227

Abstract

OBJECTIVE
The purpose of this study was to determine the prognostic implications of the pretreatment neutrophil-to-lymphocyte ratio (NLR) and its dynamic change during chemotherapy in patients with advanced epithelial ovarian cancer undergoing neoadjuvant chemotherapy.
METHODS
We performed a retrospective analysis of 203 patients who underwent neoadjuvant chemotherapy prior to interval debulking surgery for advanced-stage ovarian cancer at Yonsei Cancer Hospital between 2007 and 2015. Pretreatment NLR was evaluated before starting neoadjuvant chemotherapy. Change in NLR was defined as the post-neoadjuvant NLR value divided by the initial value. The correlation of NLR and its dynamic change with chemotherapy response score, response rate, and recurrence was analyzed.
RESULTS
The NLR ranged from 0.64 to 22.8. In univariate analyses, a higher pretreatment NLR (> 3.81) was associated with poor overall survival (OS), but not progression-free survival (PFS). Through multivariate analysis, high pretreatment NLR was shown to be an independent parameter affecting OS, but not necessarily PFS. Changes in NLR during chemotherapy were better predictors of PFS than baseline NLR. Patients with increased NLR during chemotherapy showed significantly poor PFS, and this change was an independent predictor of PFS.
CONCLUSION
Pretreatment NLR and its dynamic change during chemotherapy may be important prognostic factors in patients who undergo neoadjuvant chemotherapy.

Keyword

Biomarkers; Neutrophils; Ovarian neoplasms; Prognosis; Treatment outcomes

MeSH Terms

Biomarkers
Cancer Care Facilities
Disease-Free Survival
Drug Therapy*
Humans
Multivariate Analysis
Neutrophils
Ovarian Neoplasms*
Prognosis
Recurrence
Retrospective Studies
Biomarkers

Figure

• 

  Fig. 1 Kaplan-Meier curve of (A) (P=0.725) progression-free survival and (B) (P=0.008) overall survival stratified by neutrophil-to-lymphocyte ratio (NLR) level.

• 

  Fig. 2 Kaplan-Meier curve of (A) (P=0.006) progression-free survival and (B) (P=0.320) overall survival stratified by change of neutrophil-to-lymphocyte ratio (NLR).

• 

  Fig. 3 Kaplan-Meier curve of (A) progression-free survival and (B) overall survival according to pretreatment neutrophil-to-lymphocyte ratio (NLR) and dynamic change in NLR. LM, low pretreatment/maintained during chemotherapy; LI, low pretreatment/increased during chemotherapy; HM, high pretreatment/maintained during chemotherapy; HI, high pretreatment/increased during chemotherapy.

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