Prognostic significance of lymphocyte monocyte ratio in patients with ovarian cancer

Cai, Linrui; Song, Yanlin; Zhao, Xia

doi:10.1097/md.0000000000019638

Cited by 15 publications

(14 citation statements)

References 29 publications

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“…In the study of Lu et al, Tang et al (31), Wang et al (32), and Li et al (33) were found to contribute to the observed heterogeneity. In another MA, exclusion of studies did not reduce heterogeneity and was above 50% (19). The publication bias was assessed based on Egger's and Begg's regression and rank correlation tests in three MAs.…”

Section: Meta-analyses On the Lymphocyte-to-monocyte Ratiomentioning

confidence: 99%

Inexpensive Systemic Inflammatory Biomarkers in Ovarian Cancer: An Umbrella Systematic Review of 17 Prognostic Meta-Analyses

2021

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The association of several inflammation-based biomarkers [lymphocyte-to-monocyte, neutrophil-to-lymphocyte, and platelet-to-lymphocyte ratios (LMR, NLR, and PLR, respectively)] with the survival of epithelial ovarian cancer (EOC) patients has been extensively investigated in several systematic reviews and meta-analyses (MAs) of observational studies. The aim of this umbrella systematic review is to appraise all available results in published MAs that explored the association between these biomarkers and EOC outcomes. An umbrella systematic review of the current evidence for systemic inflammatory biomarkers in the peripheral blood of EOC patients was performed by searching several databases including PubMed/Medline and Web of Science. The quality of the MAs was appraised using the AMSTAR-2 tool as well as other qualitative criteria. The evidence was graded from convincing (Class I) to weak (Class IV). Our umbrella review appraised 17 MAs of retrospective studies (range: 7–16) with a number of enrolled patients ranging from 1,636 to 4,910 patients in each MA. All these MAs demonstrated that pretreatment high NLR and PLR, as well as low LMR, were independent predictors of poor overall survival and progression-free survival in EOC. Nearly all published MAs were conducted by Chinese researchers (16/17) and were redundant in their character. Another issue in these MAs is the absence of prior PROSPERO database registration as well as the earlier exclusion of the gray literature. On the other hand, Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analyses Of Observational Studies in Epidemiology (MOOSE)-based reporting guidelines were used in nine out of the 17 MAs. A good number of MAs have transparently provided funding acknowledgment. The AMSTAR-2-based assessment showed low quality in 11 out of the 17 reviewed MAs. This negative rating was largely due to the absence of critical domains. Finally, all evaluated MAs were rated as Class III or IV (suggestive and weak, respectively). Despite the power of MAs in increasing sampling and precision, the quality of the current non-randomized evidence on this topic is still weak.Systematic Review RegistrationPROSPERO, identifier CRD42020201493.

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Section: Meta-analyses On the Lymphocyte-to-monocyte Ratiomentioning

confidence: 99%

Inexpensive Systemic Inflammatory Biomarkers in Ovarian Cancer: An Umbrella Systematic Review of 17 Prognostic Meta-Analyses

2021

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“…C-reactive protein (CRP) has been validated as a predictive factor in solid tumors [57]. Moreover, lymphocyte to monocyte ratio has been related with ovarian cancer aggressiveness and clinical outcome in a number of studies [58,59]. Collectively, NLR could be combined with other systemic markers to increase the accuracy achieved.…”

Section: Discussionmentioning

confidence: 99%

Neutrophil-to-Lymphocyte Ratio and Chemotherapy Response Score as prognostic markers in ovarian cancer patients treated with Neoadjuvant Chemotherapy

Liontos

Andrikopoulou

Koutsoukos

et al. 2021

Preprint

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BackgroundNeoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) is the recommended approach in patients with advanced epithelial ovarian cancer (EOC). However, most patients eventually relapse despite the initial high response rate to chemotherapy. Chemotherapy response score (CRS) and neutrophil-to-lymphocyte ratio (NLR) have been identified as potential biomarkers of platinum resistance and disease prognosis. We retrospectively evaluated 132 patients with stage IIIc or IV ovarian/fallopian tube/primary peritoneal cancer who had received NACT followed by IDS from 01/01/2003 to 31/12/2018. CRS was assessed on omental specimens collected from IDS according to ICCR guidelines. ResultsMedian age was 64.57 years (SD: 9.72; range 39.2 - 87.1). Most ovarian tumors were serous epithelial (90.9%; 120/132). An elevated NLR (defined as > 3) was observed in 72% (95/132) of patients in contrast with 28% (37/132) of patients characterized by low NLR status. Median PFS (mPFS) and median overall survival (mOS) were 13.05 months (95% CI: 11.42-14.67)) and 34.69 months (95% CI: 23.26 - 46.12) respectively. In univariate analysis, CRS3 score was significantly associated with prolonged mPFS (CRS1/2: 12.79 months vs CRS3: 17.7 months; P= 0.008). CRS score was not associated with mOS (P=0.876). High NLR was not significantly associated with mPFS (P=0.128), however it was significantly associated with poor mOS (P=0.012). In multivariate analysis, only performance of surgery maintained its statistical significance with both PFS (P=0.001) and OS (P=0.008).ConclusionNLR could serve as a useful predictor of OS but not PFS in ovarian cancer patients receiving NACT. In accordance with our previous study, CRS score at omentum was found to be associated with PFS but not OS in ovarian cancer patients treated with NACT and IDS.

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“…A meta-analysis also indicated the presence of CD163+ TAMs was correlated with poor prognosis ( 110 ). A decreased lymphocyte-to-monocyte ratio (LMR) also indicated both poor overall and PFS in retrospective reviews ( 111 – 114 ).…”

Section: Innate Immunitymentioning

confidence: 99%

Driving Immune Responses in the Ovarian Tumor Microenvironment

2021

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Ovarian cancer is the leading cause of death among gynecological neoplasms, with an estimated 14,000 deaths in 2019. First-line treatment options center around a taxane and platinum-based chemotherapy regimen. However, many patients often have recurrence due to late stage diagnoses and acquired chemo-resistance. Recent approvals for bevacizumab and poly (ADP-ribose) polymerase inhibitors have improved treatment options but effective treatments are still limited in the recurrent setting. Immunotherapy has seen significant success in hematological and solid malignancies. However, effectiveness has been limited in ovarian cancer. This may be due to a highly immunosuppressive tumor microenvironment and a lack of tumor-specific antigens. Certain immune cell subsets, such as regulatory T cells and tumor-associated macrophages, have been implicated in ovarian cancer. Consequently, therapies augmenting the immune response, such as immune checkpoint inhibitors and dendritic cell vaccines, may be unable to properly enact their effector functions. A better understanding of the various interactions among immune cell subsets in the peritoneal microenvironment is necessary to develop efficacious therapies. This review will discuss various cell subsets in the ovarian tumor microenvironment, current immunotherapy modalities to target or augment these immune subsets, and treatment challenges.

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Prognostic significance of lymphocyte monocyte ratio in patients with ovarian cancer

Cited by 15 publications

References 29 publications

Inexpensive Systemic Inflammatory Biomarkers in Ovarian Cancer: An Umbrella Systematic Review of 17 Prognostic Meta-Analyses

Inexpensive Systemic Inflammatory Biomarkers in Ovarian Cancer: An Umbrella Systematic Review of 17 Prognostic Meta-Analyses

Neutrophil-to-Lymphocyte Ratio and Chemotherapy Response Score as prognostic markers in ovarian cancer patients treated with Neoadjuvant Chemotherapy

Driving Immune Responses in the Ovarian Tumor Microenvironment

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