Preoperative platelet/lymphocyte ratio is a superior prognostic factor compared to other systemic inflammatory response markers in ovarian cancer patients

Abstract

The aim of the present study was to determine the most meaningful preoperative prognostic factor of cancer-related death in ovarian cancer patients by comparing potentially prognostic systemic inflammatory response (SIR) markers. The levels of fibrinogen, albumin, C-reactive protein (CRP), and serum cancer antigen-125 (CA-125) and the neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) were evaluated in 190 ovarian cancer patients to identify predictors of overall survival (OS) and progression-free survival (PFS) using univariate and multivariate analyses. Patients with a PLR >203 had a shorter PFS and OS than the patients in PLR ≤203 group (11 vs. 24 months and 28 vs. 64 months). Univariate analyses revealed that tumor stage, postoperative residual tumor mass, ascites, and the levels of all SIR markers were associated with PFS and OS. Multivariate analysis revealed that PLR was independently associated with PFS (hazard ratio [HR] 1.852, 95% confidence interval [CI] 1.271-2.697, P = 0.001) and OS (HR 2.158, 95%CI 1.468-3.171, P< 0.001), as well as tumor stage and postoperative residual tumor mass. In contrast, fibrinogen remained significant only for PFS (HR 1.724, 95%CI 1.197-2.482, P = 0.003). Patients with a PLR >203 were more prone to have advanced tumor stage (P = 0.002), postoperative residual tumor mass >2 cm (P = 0.032), malignant ascites (P < 0.001), and all the other elevated SIR markers (P < 0.001). Preoperative PLR is superior to other SIR markers (CA-125, NLR, fibrinogen, CRP, and albumin) as a predictor of survival in ovarian cancer patients.

The platelet-to-lymphocyte ratio as a predictor of patient outcomes in ovarian cancer: a meta-analysis

“…The NOS scores, which indicated the quality of these studies, ranged from 6 to 8. Five of the selected eligible studies presented data regarding the association between the PLR and OS [14][15][16][17][18] , five studies discussed the link between PLR and PFS [15][16][17][18][19] , and six examined numerical differences in PLR between patients with malignant ovarian masses and the controls [20][21][22][23][24][25] . The disease characteristics in 12 studies are summarized in Table 2.…”

“…Five studies comprising 1051 patients investigated the association between PLR and PFS [15][16][17][18][19] . High PLR indicated an inferior PFS outcome, with a combined HR of 1.61 (95% CI 1.03-2.51, p < 0.01) (Figure 3), which indicated that patients with a higher PLR had a higher risk of disease progression than those with a low PLR.…”

Prognostic value of preoperative neutrophil-lymphocyte ratio is superior to platelet-lymphocyte ratio for survival in patients who underwent complete resection of thymic carcinoma

“…A number of inflammation markers have been evaluated to stratify patients for treatment and to predict survival (9). The prognostic value of preoperative systemic inflammationrelated neutrophil-lymphocyte ratio (NLR) and plateletlymphocyte ratio (PLR) has been demonstrated in patients with a variety of cancers (10)(11)(12)(13)(14)(15)(16)(17)(18). However, no previous studies have evaluated the association between NLR and PLR with the prognosis of thymic tumors.…”

Does preoperative neutrophil to lymphocyte or platelet to lymphocyte ratios have a role in predicting borderline ovarian tumors?

“…[11]. Furthermore, Zhang and colleagues presumed that preoperative PLR was superior to the other SIR markers (CA-125, NLR, fibrinogen, CRP, and albumin) as a predictor of survival in ovarian cancer patients [7]. Although several studies investigated the association between preoperative NLR and PLR with invasive ovarian cancers, to the best of our knowledge, there were no reported studies in the literature which researched these markers in the BOTs.…”

“…As preoperative inflammatory markers, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been suggested to be useful for discriminating malignant and benign ovarian tumors. NLR and PLR are noninvasive, easily measured, universally known and cost-effective markers [5–7]. …”