The Impact of Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in Epithelial Ovarian Cancer

Abstract

OBJECTIVE: This study aims to investigate the prognostic value of the preoperative neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in patients with epithelial ovarian cancer.

STUDY DESIGN: Between January 2012 and December 2018, the data and preoperative levels of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio of 116 epithelial ovarian cancer patients were retrospectively collected. The association of these relevant markers with outcomes was analyzed.

RESULTS: The difference was observed concerning optimal and suboptimal debulking in platelet-to-lymphocyte ratio ratios (p=0.04). Lymphovascular space involvement was significantly associated with higher platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio ratios (p<0.0001). Patients with ascites and lymph node involvement had a higher platelet-to-lymphocyte ratio ratio (p=0.007 and p=0.004). In recurrences, higher ratios of platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio were observed (p=0.03 and p=0.02). The analysis revealed that platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio were not independent prognostic factors for recurrence (p=0.783 and p=0.391). Regarding mortality, platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio were not independently prognostic (p=0.621 and p=0.830). It was determined that neutrophil-to-lymphocyte ratio >2.45 (HR 0.714, CI 0.622-0.794, p<0.0001) and platelet-to-lymphocyte ratio >179.4 (HR 0.736, CI 0.646-0.814, p<0.0001) could predict the presence of recurrence with a certain sensitivity and specificity, and for predicting the death, a neutrophil-to-lymphocyte ratio of >2.45 had a sensitivity of 78.26% (95% CI: 56.3 to 92.5%) and a specificity of 54.84% (95%CI: 44.2 - 65.2) (p=0.03).

CONCLUSION: The evaluation of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio is important in obtaining prognostic information before surgery. However, no significant association between the neutrophil-to-lymphocyte ratio or platelet-to-lymphocyte ratio with survival was identified.