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J Cancer 2018; 9(7):1127-1134. doi:10.7150/jca.24057 This issue Cite

Research Paper

Prognostic value of preoperative lymphocyte-monocyte ratio in patients with ovarian clear cell carcinoma

Byung Su Kwon^1,#, Dae Hoon Jeong^2,#, Jung Mi Byun², Tae Hwa Lee³, Kyung Un Choi⁴, Yong Jung Song¹, Dong Soo Suh^1,*,✉, Ki Hyung Kim^1,5,*,✉

1. Department of Obstetrics and Gynecology, Pusan National University School of Medicine, and Biomedical Research Institute and Pusan Cancer Center, Pusan National University Hospital, Busan, South Korea
2. Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, Busan, South Korea
3. Department of Obstetrics and Gynecology, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, South Korea
4. Department of Pathology, Pusan National University School of Medicine, Busan, South Korea
5. Biomedical Research Institute and Pusan Cancer Center, Pusan National University Hospital, Busan, South Korea
^#BS Kwon and DH Jeong contributed equally to the study.
^*DS Suh and Kim KH contributed equally to this work.

✉ Corresponding author: Ki Hyung Kim, MD, Ph.D., Department of Obstetrics and Gynecology, Pusan National University School of Medicine, Biomedical Research Institute and Pusan Cancer Center, Pusan National University Hospital, Busan, South Korea, Tel: 82-51-240-7287 FAX: 82-51-248-2384, E-mail: ghkimac.kr and Dong Soo Suh, MD, Ph.D., Department of Obstetrics and Gynecology, Pusan National University School of Medicine, 49241 Busan, South Korea, Tel: 82-51-240-7287 FAX: 82-51-248-2384, E-mail: dssuhac.kr More

Abstract

Objective: The aim of the present study was to determine the prognostic significances of markers of preoperative systemic inflammatory response (SIR) in patients with ovarian clear cell carcinoma (OCCC).

Methods: A total of 109 patients diagnosed with OCCC that underwent primary cytoreductive surgery and adjuvant platinum-based chemotherapy from 2009 to 2012 were enrolled in this retrospective study. SIR markers were calculated from complete blood cell counts determined before surgery. Receiver operating characteristic (ROC) curve analysis was used to determine optimal cut-off values for neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR). Prognostic significances with respect to overall survival (OS) and progression-free survival (PFS) were determined by Kaplan-Meier curve and multivariate Cox regression analysis.

Results: The optimized NLR, LMR and PLR cut-off values as determined by ROC curve analysis for PFS and OS were 2.3, 4.2, and 123.6, respectively. When the cohort was divided using these optimized cut-offs, NLR and LMR were found to be significantly associated with clinicopathologic factors, NLR with FIGO stage, the presence of malignant ascites, and platinum response, and LMR with FIGO stage, lymph node metastasis, malignant ascites, and platinum response. Kaplan-Meier analysis revealed a high NLR (> 2.3) was significantly associated with low 5-year PFS and OS rates and that a high LMR was significantly associated with high 5-year PFS and OS rates. Multivariate analysis identified FIGO stage, residual mass, and platinum response as independent prognostic factors of PFS, and FIGO stage, residual mass, platinum response, and LMR as independent prognostic factors of OS.

Conclusions: Markers of systemic inflammatory response provide useful prognostic information and lymphocyte-to-monocyte ratio is the most reliable independent prognostic factor of overall survival in patients with ovarian clear cell carcinoma.

Keywords: Ovarian clear cell carcinoma, systemic inflammatory response, neutrophil-to-lymphocyte ratio, lymphocyte-monocyte ratio, platelet-to-lymphocyte ratio, survival.

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