J Cancer 2017; 8(5):737-743. doi:10.7150/jca.17668

Research Paper

Peripheral blood lymphocyte-to-monocyte ratio as a prognostic factor in advanced epithelial ovarian cancer: a multicenter retrospective study

Jia-yu Zhu1*, Cheng-cheng Liu2*, Liang Wang3, Mei Zhong1, Hai-lin Tang2✉, Hua Wang3 ✉

1. Department of Obstetrics and Gynecology, Nanfang Hospital of Southern Medical University, Guangzhou 510515, P.R. China;
2. Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China
Collaborative Innovation Centre for Cancer Medicine, Guangzhou 510060, P. R. China
3. Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China; Collaborative Innovation Centre for Cancer Medicine, Guangzhou 510060, P. R. China; Department of Hematological Oncology, Sun Yat-Sen University Cancer Center, Guangzhou 510060, P. R. China.
* Jia-yu Zhu, Cheng-cheng Liu and Liang Wang contributed equally to this article.

Abstract

The lymphocyte-to-monocyte ratio (LMR), as a surrogate marker of systemic inflammation, has been found to be a novel prognostic indicator in various malignancies. Data from 672 advanced epithelial ovarian cancer (EOC) patients treated with neoadjuvant chemotherapy (NAC) followed by debulking surgery were analyzed, and the prognostic value of LMR were evaluated. The optimal cutoff point of LMR in prediction of survival was defined as 3.45 through receiver operating characteristics curve analysis. Patients with low LMR (≤3.45) at diagnosis tended to have more adverse clinical features, such as higher histological grade, chemotherapy resistance, and residual tumor >1cm after debulking surgery. No significant correlation was found between LMR level and age and histological type. Moreover, after NAC, the complete remission (CR) rate for the low-LMR group was lower than those for the high-LMR group (P<0.05). Patients with low LMR had poorer progression-free survival (PFS; P<0.001) and overall survival (OS; P<0.001). Multivariate analysis revealed that low LMR was an independent adverse predictor for PFS and OS. Results indicated that low LMR at diagnosis is a novel independent prognostic factor for advanced EOC. However, prospective study is needed to validate this prognostic factor and biological studies should further investigate the mechanisms underlying the correlation between low LMR and poor prognosis in advanced EOC.

Keywords: lymphocyte-to-monocyteratio, epithelial ovarian cancer, neoadjuvant chemotherapy, prognosis

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How to cite this article:
Zhu Jy, Liu Cc, Wang L, Zhong M, Tang Hl, Wang H. Peripheral blood lymphocyte-to-monocyte ratio as a prognostic factor in advanced epithelial ovarian cancer: a multicenter retrospective study. J Cancer 2017; 8(5):737-743. doi:10.7150/jca.17668. Available from http://www.jcancer.org/v08p0737.htm