J Cancer 2016; 7(13):1772-1779. doi:10.7150/jca.15724

Research Paper

Preoperative Lymphocyte-Monocyte Ratio Is a Predictor of Suboptimal Cytoreduction in Stage III-IV Epithelial Ovarian Cancer

Wankyu Eo1, Hong-Bae Kim2, Yong Joo Lee3✉*, Dong Soo Suh4, Ki Hyung Kim4✉*, Heungyeol Kim5

1. Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul, Korea;
2. Department of Obstetrics and Gynecology, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Seoul, Korea;
3. Department of Medicine, Pusan National University Graduate School;
4. Department of Obstetrics and Gynecology, Pusan National University School of Medicine; Biomedical Research Institute, Pusan National University Hospital, Busan, Korea;
5. Department of Obstetrics and Gynecology, College of Medicine, Kosin University, Busan, Korea.
*These authors equally contributed to this work.


Objective: To determine whether the preoperative lymphocyte-monocyte ratio (LMR) is a predictor of suboptimal cytoreduction in advanced-stage epithelial ovarian cancer (EOC).

Methods: Preoperative clinico-pathologic and hematologic parameters were reviewed in a total of 154 patients with EOC submitted to primary cytoreductive surgery. Patients were categorized into two different groups according to the results of cytoreductive surgery: optimal and suboptimal cytoreduction. Continuous variables were categorized into two groups using the best cutoff points selected on the receiver operating characteristic (ROC) curve for suboptimal cytoreduction.

Results: Based on data collected from the 154 patients, 133 (86.4%) and 21 (13.6%) patients presented with stage III and IV disease, respectively. One hundred seventeen (76.0%) patients had serous adenocarcinoma, and 92 (59.7%) had histologic tumor grade 3. The optimal and suboptimal cytoreduction groups included 96 (62.3%) and 58 patients (37.7%), respectively. The best LMR cutoff point for suboptimal cytoreduction was 3.75. On multivariate logistic regression analysis, age, cancer antigen 125, white blood cell count, and LMR were found to be the strongest predictors for suboptimal cytoreduction (P=0.0037, 0.0249, 0.0062, and 0.0015, respectively).

Conclusion: Preoperative LMR is an independent predictor of suboptimal cytoreduction. It provides additional prognostic information beyond the biological parameters of the tumor.

Keywords: Lymphocytes, Monocytes, Cytoreduction Surgical Procedures, Ovarian neoplasms.

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How to cite this article:
Eo W, Kim HB, Lee YJ, Suh DS, Kim KH, Kim H. Preoperative Lymphocyte-Monocyte Ratio Is a Predictor of Suboptimal Cytoreduction in Stage III-IV Epithelial Ovarian Cancer. J Cancer 2016; 7(13):1772-1779. doi:10.7150/jca.15724. Available from http://www.jcancer.org/v07p1772.htm