Hematologic markers of distant metastases and poor prognosis in gynecological cancers

Abstract

BackgroundDespite the recent progress in the development of anti-cancer drugs, the treatment of metastatic tumors is usually ineffective. The systemic inflammatory response performs key roles in different stages of the carcinogenesis process including metastasis. The high neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), and platelet-lymphocyte ratio (PLR) were found to be associated with poor survival rates in the majority of solid tumors. However, only a few studies were conducted to further investigate this association in patients with advanced gynecological cancers.MethodsClinical data from 264 patients with FIGO stage III and IV gynecological (endometrial, ovarian and cervical) cancers treated at King Hussein Cancer Center (Amman-Jordan) from 2006 to 2012 were retrospectively reviewed. We examined the association between absolute neutrophil count (ANC), absolute monocyte count (AMC), MLR, PLR, and NLR with distant metastases, overall survival and event-free survival in gynecological cancers. For survival analysis, Receiver Operating Characteristic (ROC) curve analysis was operated to determine the optimal cutoff values.ResultsPatients with high baseline NLR (≥4.1) had more baseline distant metastases than patients with low baseline NLR (< 4.1), (p-value 0.045). Patients with high baseline AMC (≥560) had more distant metastases in comparison to patients with low baseline AMC (< 560), (p-value 0.040). Furthermore, Patients with high baseline PLR (≥0.3) had more distant metastases in comparison to patients with low baseline PLR (< 0.3), (p-value 0.025). Additionally, patients with high baseline ANC (≥5700) had worse overall survival compared to the patients with low baseline ANC (< 5700), (p-value 0.015). Also, patients with high baseline AMC (≥490) had worse overall survival compared to the patients with low baseline AMC (< 490), (p-value 0.044).ConclusionDifferent hematologic markers obtained from a cheap test (CBC) could potentially be used to predict the presence of distant metastases thus used as prognostic indices in gynecological cancers.

Comparison of Inflammatory Indexes In Patients Treated With Sorafenib In Advanced Hepatocellular Carcinoma: A Single Center Observational Study

“…Neutrophil secretes vascular endothelial growth factor (VEGF) and proteases, such as matrix metalloproteinase and elastase enzymes, causing cancer cells to invade and metastasize. Monocytes also increase cancer cell migration and inhibit immunity to the tumor cell (12). Although there was no statistically significant difference in our study, it was thought that the high level of monocyte value might be important for the response to the tumor.…”

Prognostic role of lymphocyte-to-monocyte ratio in pancreatic neuroendocrine neoplasms

“…Some previous articles reported that the distributions of serum inflammation markers were different between metastatic and non-metastatic tumors (15). Thus, we first evaluated the distributions of NLR, PLR, LMR, SII index, lymphocyte count, monocyte count and neutrophil count between liver metastatic and non-metastatic pNENs, and statistical analysis indicated that none of these markers distributed differently between the two groups ( Supplementary Fig.…”

Predictive and prognostic values of preoperative platelet parameters in patients with gynecological tumors

“…For FIGO stages, I and II were defined as early stage, while III and IV were defined as advanced stage. 10,12…”

“…5 In addition, a growing body of evidence has found that platelets also play a role in tumor cell growth, metastasis, and angiogenesis. 6,7 Decades of studies indicated that platelet indicators are important prognostic factors in patients with different types of cancer, such as gynecologic cancers, [8][9][10][11][12][13] lung cancer, 14,15 gastric cancer, 16 colorectal cancer, 5 pancreatic cancer, 17,18 laryngeal cancer, 19 and rectal cancer. 20 Thrombocytosis may precede the diagnosis of malignancy.…”