Obstet Gynecol Sci.  2023 Sep;66(5):407-416. 10.5468/ogs.23119.

Pretreatment total lymphocyte count as a prognostic factor of survival in patients with recurrent cervical cancer after definitive radiation-based therapy: a retrospective study

• Thiangphak E
• Leetanaporn K
• Buhachat R

• KMID: 2545887
• DOI: http://doi.org/10.5468/ogs.23119

Abstract

Objective
This study evaluated the association between pretreatment total lymphocyte count (TLC) and overall survival (OS) in patients with recurrent cervical cancer.
Methods
We retrospectively reviewed 290 patients with recurrent cervical cancer with definite complete responses to either definitive radiotherapy or concurrent chemoradiotherapy between January 2009 and December 2022. The associations between pretreatment TLC and progression-free survival (PFS) and OS rates were evaluated.
Results
Ninety-three patients (32%) had a pretreatment TLC <1,000 cells/mm³. Patients with a pretreatment TLC <1,000 cells/mm³ had lower treatment response rates than their counterparts (P=0.045). The OS and PFS rates were significantly higher in patients with pretreatment TLC ≥1,000 cells/mm³ than in those with pretreatment TLC <1,000 cells/mm³ (10.74 vs. 3.89 months, P<0.0001; 8.32 vs. 4.97 months, P=0.042; respectively). Moreover, pretreatment TLC ≥1,000 cells/mm³ was identified as an independent prognostic factor for OS in both univariate analysis (hazard ratio [HR], 0.57; 95% conficence interval [CI], 0.44-0.74; P<0.001) and multivariate analysis (HR, 0.64; 95% CI, 0.47-0.86; P=0.003). However, TLC ≥1,000 cells/mm3 was identified as a prognostic factor for PFS only in univariate analysis (HR, 0.71; 95% CI, 0.51-0.99; P=0.043) but not in the multivariate analysis (HR, 0.81; 95% CI, 0.55-1.18; P=0.3).
Conclusion
Pretreatment TLC was associated with treatment response and was identified as an independent prognostic factor associated with the survival outcomes of patients with recurrent cervical cancer.

Keyword

Cervical cancer; Total lymphocyte count; Survival rate; Progression-free survival; Squamous cell carcinoma

Figure

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  Fig. 1 Overall survival (A) and progression-free survival (B) in patients with recurrent cervical cancer, stratified according to pretreatment total lymphocyte count. TLC, total lymphocyte count.

Reference

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