Neutrophil-lymphocyte ratio as a predictor of oncologic outcomes in stage IVB, persistent, or recurrent cervical cancer patients treated by chemotherapy

© 2019 The Author(s). Background: Cervical cancer patients with stage IVB, persistent, or recurrent disease after complete primary treatment are usually treated with systemic chemotherapy. Circulating blood components have been a target of study relative to their ability to predict cancer outcomes;...

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Main Authors: Pornprom Ittiamornlert, Irene Ruengkhachorn
Other Authors: Faculty of Medicine, Siriraj Hospital, Mahidol University
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Published: 2020
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Online Access:https://repository.li.mahidol.ac.th/handle/123456789/50292
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spelling th-mahidol.502922020-01-27T17:13:50Z Neutrophil-lymphocyte ratio as a predictor of oncologic outcomes in stage IVB, persistent, or recurrent cervical cancer patients treated by chemotherapy Pornprom Ittiamornlert Irene Ruengkhachorn Faculty of Medicine, Siriraj Hospital, Mahidol University Biochemistry, Genetics and Molecular Biology Medicine © 2019 The Author(s). Background: Cervical cancer patients with stage IVB, persistent, or recurrent disease after complete primary treatment are usually treated with systemic chemotherapy. Circulating blood components have been a target of study relative to their ability to predict cancer outcomes; however, no previous study has focused on patients with advanced, persistent, or recurrent cervical carcinoma who were treated by chemotherapy, which adversely affects hematopoietic and immune activity. The predictive value of complete blood cell differential counts in patients with stage IVB, persistent, or recurrent cervical cancer treated by chemotherapy, may be able to triage these patients. Methods: This retrospective chart review was conducted in cervical cancer patients with stage IVB disease, persistent disease, or recurrent disease who were treated by chemotherapy during January 2006 to January 2017 were reviewed. Follow-up data were collected through July 2017. Results: A total of 355 cervical carcinoma patients were included. Of those, 63 patients received chemotherapy as primary treatment, and 292 patients received chemotherapy for persistent or recurrent disease. Mean age was 52.5 ± 10.3 years, median age was 51.9 years (IQR: 45.0-59.7), and mean BMI was 23.3 ± 4.9 kg/m 2 . Overall response rate was 37.5%, with a median progression free survival (PFS) of 5.7 months, and with a median overall survival (OS) of 38.1 months. Multivariate analysis revealed elevated platelet count (> 400,000/mm 3 ), squamous cell carcinoma subtype, and distant metastasis to be associated with poorer PFS. Elevated neutrophil count (> 7000/mm 3 ), elevated platelet count (> 400,000/mm 3 ), squamous cell carcinoma subtype, and distant metastasis were found to be associated with poorer OS. Neutrophil-lymphocyte ratio ≥ 3.6 was the most valuable predictor of poor oncologic outcome relative to overall response rate (odds ratio = 1.642, 95% confidence interval [CI]: 1.048-2.572, P = 0.030), PFS (hazard ratio [HR] = 1.676, 95% CI: 1.334-2.107, P < 0.001), and OS (HR = 2.544, 95% CI: 1.672-3.870, P < 0.001). Conclusions: Neutrophil-lymphocyte ratio ≥ 3.6 was identified as an independent predictor of poor oncologic outcome relative to overall response rate, PFS and OS. 2020-01-27T07:51:20Z 2020-01-27T07:51:20Z 2019-01-10 Article BMC Cancer. Vol.19, No.1 (2019) 10.1186/s12885-019-5269-1 14712407 2-s2.0-85059828670 https://repository.li.mahidol.ac.th/handle/123456789/50292 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85059828670&origin=inward
institution Mahidol University
building Mahidol University Library
continent Asia
country Thailand
Thailand
content_provider Mahidol University Library
collection Mahidol University Institutional Repository
topic Biochemistry, Genetics and Molecular Biology
Medicine
spellingShingle Biochemistry, Genetics and Molecular Biology
Medicine
Pornprom Ittiamornlert
Irene Ruengkhachorn
Neutrophil-lymphocyte ratio as a predictor of oncologic outcomes in stage IVB, persistent, or recurrent cervical cancer patients treated by chemotherapy
description © 2019 The Author(s). Background: Cervical cancer patients with stage IVB, persistent, or recurrent disease after complete primary treatment are usually treated with systemic chemotherapy. Circulating blood components have been a target of study relative to their ability to predict cancer outcomes; however, no previous study has focused on patients with advanced, persistent, or recurrent cervical carcinoma who were treated by chemotherapy, which adversely affects hematopoietic and immune activity. The predictive value of complete blood cell differential counts in patients with stage IVB, persistent, or recurrent cervical cancer treated by chemotherapy, may be able to triage these patients. Methods: This retrospective chart review was conducted in cervical cancer patients with stage IVB disease, persistent disease, or recurrent disease who were treated by chemotherapy during January 2006 to January 2017 were reviewed. Follow-up data were collected through July 2017. Results: A total of 355 cervical carcinoma patients were included. Of those, 63 patients received chemotherapy as primary treatment, and 292 patients received chemotherapy for persistent or recurrent disease. Mean age was 52.5 ± 10.3 years, median age was 51.9 years (IQR: 45.0-59.7), and mean BMI was 23.3 ± 4.9 kg/m 2 . Overall response rate was 37.5%, with a median progression free survival (PFS) of 5.7 months, and with a median overall survival (OS) of 38.1 months. Multivariate analysis revealed elevated platelet count (> 400,000/mm 3 ), squamous cell carcinoma subtype, and distant metastasis to be associated with poorer PFS. Elevated neutrophil count (> 7000/mm 3 ), elevated platelet count (> 400,000/mm 3 ), squamous cell carcinoma subtype, and distant metastasis were found to be associated with poorer OS. Neutrophil-lymphocyte ratio ≥ 3.6 was the most valuable predictor of poor oncologic outcome relative to overall response rate (odds ratio = 1.642, 95% confidence interval [CI]: 1.048-2.572, P = 0.030), PFS (hazard ratio [HR] = 1.676, 95% CI: 1.334-2.107, P < 0.001), and OS (HR = 2.544, 95% CI: 1.672-3.870, P < 0.001). Conclusions: Neutrophil-lymphocyte ratio ≥ 3.6 was identified as an independent predictor of poor oncologic outcome relative to overall response rate, PFS and OS.
author2 Faculty of Medicine, Siriraj Hospital, Mahidol University
author_facet Faculty of Medicine, Siriraj Hospital, Mahidol University
Pornprom Ittiamornlert
Irene Ruengkhachorn
format Article
author Pornprom Ittiamornlert
Irene Ruengkhachorn
author_sort Pornprom Ittiamornlert
title Neutrophil-lymphocyte ratio as a predictor of oncologic outcomes in stage IVB, persistent, or recurrent cervical cancer patients treated by chemotherapy
title_short Neutrophil-lymphocyte ratio as a predictor of oncologic outcomes in stage IVB, persistent, or recurrent cervical cancer patients treated by chemotherapy
title_full Neutrophil-lymphocyte ratio as a predictor of oncologic outcomes in stage IVB, persistent, or recurrent cervical cancer patients treated by chemotherapy
title_fullStr Neutrophil-lymphocyte ratio as a predictor of oncologic outcomes in stage IVB, persistent, or recurrent cervical cancer patients treated by chemotherapy
title_full_unstemmed Neutrophil-lymphocyte ratio as a predictor of oncologic outcomes in stage IVB, persistent, or recurrent cervical cancer patients treated by chemotherapy
title_sort neutrophil-lymphocyte ratio as a predictor of oncologic outcomes in stage ivb, persistent, or recurrent cervical cancer patients treated by chemotherapy
publishDate 2020
url https://repository.li.mahidol.ac.th/handle/123456789/50292
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