The Prognostic Value of Peripheral Inflammatory Cell Ratios in Patients with Cervical Cancer After Radiotherapy

Abstract Introduction: This study aimed to explore the values of the neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) as prognostic biomarkers in patients with cervical cancer.Methods: In total, 172 cervical cancer patients treated with radiotherapy between January 2014 and December 2017 were retrospectively identified. We calculated the NLR and PLR and determined their cut-off points, known prognostic factors, and the association of these factors with overall survival (OS).Results: The median follow-up period was 59 months (range 1–91 months, 95% confidence interval 53–63 months). The 3- and 5-year OS rates of patients who received postoperative adjuvant radiotherapy were 86.7% and 79.7%, respectively, while the 3- and 5-year OS rates of patients who received radical radiotherapy were 70.2% and 61.6%, respectively. Univariate analysis identified that OS was significantly correlated with tumor diameter, pelvic lymph node status, the NLR and PLR before radiotherapy, past diabetes, International Federation of Gynecology and Obstetrics (FIGO) stage, the purpose of radiotherapy, pathology type, and the OS rate (all P<0.05). On multivariate analysis, the PLR before radiotherapy, past diabetes, FIGO stage, and pathology type were independently associated with OS (all P<0.05). Conclusions: The NLR and PLR before radiotherapy are correlated with the prognosis of cervical cancer. Furthermore, the PLR before radiotherapy is an independent risk factor related to OS.

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Abdominal Scar Recurrences of Cervical Cancer: Incidence and Characteristics: A Case-Control Study

International Journal of Gynecological Cancer ◽

10.1111/igc.0b013e3181db5153 ◽

2010 ◽

Vol 20 (6) ◽

pp. 1031-1040 ◽

Cited By ~ 4

Author(s):

Sabrina A. H. M. van den Tillaart ◽

Annelies Schoneveld ◽

Inge T. Peters ◽

J. Baptist M. Trimbos ◽

Astrid Van Hylckama Vlieg ◽

...

Keyword(s):

Cervical Cancer ◽

Recurrent Disease ◽

Figo Stage ◽

Resection Margins ◽

Control Group ◽

Case Group ◽

Tumor Diameter ◽

Gynecology And Obstetrics ◽

Mean Time

Background:Tumor recurrence in the surgical scar after radical hysterectomy for cervical cancer has been reported, but the incidence is unknown. Facts about patient and tumor characteristics and follow-up are lacking. The objective of this study was to analyze the incidence and characteristics of cervical cancer scar recurrences.Methods:All patients who were surgically treated for cervical cancer in our center between 1984 and 2007 were reviewed for scar recurrences. For each case, 5 random controls were selected. Clinical characteristics were compared between the cases and controls.Results:Eleven (1.3%) of 842 patients developed a scar recurrence. Mean time between surgery and scar recurrence was 16 months (range, 2-45 months). For 8 patients (73%), the scar recurrence was the first disease recurrence. Five patients (45%) died, and 2 (18%) were lost to follow-up. Mean time between scar recurrence and death was 9 months. Ninety-one percent of the cases had recurrent disease besides the scar recurrence during follow-up. The case group had a higher percentage of advanced FIGO (International Federation of Gynecology and Obstetrics) stage and postoperatively found involvement of parametria or resection margins and tumor diameter greater than 4 cm, whereas lymph nodes were more often involved in the control group.Conclusions:The incidence of scar recurrences after primary surgery for cervical cancer was 1.3%. Time to development was variable, and prognosis was poor. Besides higher FIGO stage and concurrent unfavorable pathological characteristics, we found no outstanding characteristics of patients with scar recurrence. Scar recurrences go hand in hand with recurrent disease at other locations and seem a manifestation of tumors with extensive metastatic potential.

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Platelet-to-lymphocyte ratio and C-reactive protein as markers for colorectal polyp histological type

BMC Cancer ◽

10.1186/s12885-021-08221-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Rui Chen ◽

Liguang Wang ◽

Qi Zhao ◽

Zhen Li ◽

Man Chen ◽

...

Keyword(s):

Multivariate Analysis ◽

Univariate Analysis ◽

Colorectal Polyp ◽

Histological Type ◽

Endoscopic Polypectomy ◽

Tumor Diameter ◽

C Reactive Protein ◽

Platelet To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Reactive Protein

Abstract Background The platelet-to-lymphocyte ratio (PLR) and C-reactive protein (CRP) level are markers that have been reported to predict the histological type of various tumors, and here, we evaluated their utility in predicting colorectal polyp histological types. Methods We retrospectively reviewed 172 patients with colorectal polyps who underwent endoscopic polypectomy. The associations between histological type and clinicopathologic parameters were assessed by multivariate analysis. Results The optimal PLR and CRP cut-off values were 113.32 and 0.39, respectively. The PLR (P = 0.002) and CRP (P = 0.009) values were associated with the histological type according to the univariate analysis, whereas low PLR (P ≤ 0.001) and CRP (P = 0.017) values were independent risk factors in the multivariate analysis together with maximum tumor diameter (P ≤ 0.001) and tumor number (P = 0.0014). Conclusions Preoperative PLR and CRP are correlated with the colorectal polyp histological type.

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P27 as a Prognostic Factor of Early Cervical Carcinoma

International Journal of Gynecological Cancer ◽

10.1097/igc.0b013e318277edc8 ◽

2013 ◽

Vol 23 (1) ◽

pp. 164-169 ◽

Cited By ~ 6

Author(s):

Jiri Bouda ◽

Ondrej Hes ◽

Miroslava Koprivova ◽

Martin Pesek ◽

Tomas Svoboda ◽

...

Keyword(s):

Prognostic Factors ◽

Lymph Node ◽

Prognostic Factor ◽

Cervical Carcinoma ◽

Univariate Analysis ◽

Figo Stage ◽

Lymph Node Status ◽

Tumor Diameter ◽

Stage Ib ◽

Node Status

ObjectiveThe aim of this study was to clarify whether the evaluation of cell-cycle regulatory protein p27 can serve as a prognostic factor in patients with International Federation of Gynecology and Obstetrics (FIGO) stage IB cervical carcinoma.Patients and MethodsA retrospective study was performed on 130 surgically treated patients with FIGO stage IB cervical carcinoma with at least a 5-year follow-up. The expression of p27 was investigated independently by 2 experienced pathologists using immunohistochemistry. The prognostic significance of established prognostic factors and p27 expression were analyzed using univariate and multivariate analyses.ResultsIn a univariate analysis, lymph node status, tumor diameter, Gynecologic Oncology Group (GOG) score, lymph vascular space invasion, and p27 expression were significant prognostic factors for overall survival (OS). We found a correlation between p27 expression and lymph node status, tumor diameter, invasion, and GOG score. The p27 expression was a statistically significant prognostic factor for OS in a univariate analysis (log-rank test, P = 0.03). In a multivariate analysis, only lymph node status and tumor diameter were statistically significant prognostic factors for OS.ConclusionsThis study demonstrated that a low p27 expression is associated with lymph node metastasis, deep stromal invasion, tumor diameter more than 20 mm, and high GOG score and had a prognostic influence on OS in a univariate analysis in a series of 130 women with FIGO stage IB cervical carcinoma. Lymph node status and the diameter of the tumor were the only statistically significant prognostic factors in multivariate analysis.

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P16 and HPV Genotype Significance in HPV-Associated Cervical Cancer—A Large Cohort of Two Tertiary Referral Centers

International Journal of Molecular Sciences ◽

10.3390/ijms22052294 ◽

2021 ◽

Vol 22 (5) ◽

pp. 2294

Author(s):

Sara da Mata ◽

Joana Ferreira ◽

Inmaculada Nicolás ◽

Susana Esteves ◽

Gonçalo Esteves ◽

...

Keyword(s):

Cervical Cancer ◽

Advanced Disease ◽

Univariate Analysis ◽

Prognostic Significance ◽

Figo Stage ◽

Hpv Infection ◽

Gynecology And Obstetrics ◽

Worse Prognosis ◽

P16 Expression ◽

P16 Overexpression

The expression of p16 is a good surrogate of human papillomavirus (HPV) infection in HPV-associated cancers. The significance of p16 expression, HPV genotype and genera in the outcome of patients with HPV-associated cervical cancer (CC) is unclear. Our aim is to ascertain the prognostic significance of these factors. Data from 348 patients (median age: 47.5 years old) with CC, diagnosed in two referral centers, were retrospectively collected. Advanced disease (FIGO2018 IB2-IV) was present in 68% of patients. A single HPV genotype was identified in 82.8% of patients. The most common HPVs were HPV16 (69%) and HPV18 (14%). HPV genera reflected this distribution. HPV16 tumors presented at an earlier stage. P16 was negative in 18 cases (5.2%), 83.3% of which were squamous cell carcinomas. These cases occurred in older patients who tended to have advanced disease. In the univariate analysis, HPV16 (HR: 0.58; p = 0.0198), α-9 genera (HR: 0.37; p = 0.0106) and p16 overexpression (HR: 0.54; p = 0.032) were associated with better survival. HPV16 (HR: 0.63; p = 0.0174) and α-9 genera (HR: 0.57; p = 0.0286) were associated with less relapse. In the multivariate analysis, only the International Federation of Gynecology and Obstetrics (FIGO) stage retained an independent prognostic value. HPV16, α-9 genera and p16 overexpression were associated with better survival, although not as independent prognostic factors. Patients with p16-negative HPV-associated CC were older, presented with advanced disease and had worse prognosis.

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Is salvage radiotherapy optimal to patients with occult cervical cancer undergoing inadvertent simple hysterectomy? A propensity score-matched analysis of a nationwide clinical oncology database

Japanese Journal of Clinical Oncology ◽

10.1093/jjco/hyaa251 ◽

2021 ◽

Author(s):

Yanhong Wang ◽

Yi Ouyang ◽

Jingjing Su ◽

Lihua Xiao ◽

Zhigang Bai ◽

...

Keyword(s):

Cervical Cancer ◽

Overall Survival ◽

Propensity Score ◽

Radical Surgery ◽

Figo Stage ◽

Salvage Radiotherapy ◽

Radiotherapy Group ◽

Surgery Group ◽

Group Matching

Abstract Objective We used National Cancer Institute’s Surveillance, Epidemiology and End Result database to assess the role of salvage radiotherapy for women with unanticipated cervical cancer after simple hysterectomy. Methods Patients with non-metastatic cervical cancer and meeting inclusion criteria were divided into three groups based on treatment strategy: simple hysterectomy, salvage radiotherapy after hysterectomy and radical surgery. Parallel propensity score-matched datasets were established for salvage radiotherapy group vs. simple hysterectomy group (matching ratio 1: 1), and salvage radiotherapy group vs. radical surgery group (matching ratio 1:2). The primary endpoint was the overall survival advantage of salvage radiotherapy over simple hysterectomy or radical surgery within the propensity score-matched datasets. Results In total, 2682 patients were recruited: 647 in the simple hysterectomy group, 564 in the salvage radiotherapy group and 1471 in the radical surgery group. Age, race, histology, grade, FIGO stage, insured and marital status and chemotherapy were comprised in propensity score-matched. Matching resulted in two comparison groups with neglectable differences in most variables, except for black race, FIGO stage III and chemotherapy in first matching. In the matched analysis for salvage radiotherapy vs. simple hysterectomy, the median follow-up time was 39 versus 32 months. In the matched analysis for salvage radiotherapy vs. radical surgery, the median follow-up time was 39 and 41 months, respectively. Salvage radiotherapy (HR 0.53, P = 0.046) significantly improved overall survival compared with simple hysterectomy, while salvage radiotherapy cannot achieve similar overall survival to radical surgery (HR 1.317, P = 0.045). Conclusions This is the largest study of the effect of salvage radiotherapy on overall survival in patients with unanticipated cervical cancer. Salvage radiotherapy can improve overall survival compared with hysterectomy alone, while cannot achieve comparable survival to radical surgery.

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Combining Carcinoembryonic Antigen and Platelet to Lymphocyte Ratio to Predict Brain Metastasis of Resected Lung Adenocarcinoma Patients

BioMed Research International ◽

10.1155/2017/8076384 ◽

2017 ◽

Vol 2017 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Wei Wang ◽

Chao Bian ◽

Di Xia ◽

Jin-Xi He ◽

Ping Hai ◽

...

Keyword(s):

Risk Factors ◽

Brain Metastasis ◽

Lung Adenocarcinoma ◽

Carcinoembryonic Antigen ◽

Roc Curve ◽

Univariate Analysis ◽

Significant Risk ◽

Platelet To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Increased Risk

We aimed to evaluate the role of pretreatment carcinoembryonic antigen (CEA) and platelet to lymphocyte ratio (PLR) in predicting brain metastasis after radical surgery for lung adenocarcinoma patients. The records of 103 patients with completely resected lung adenocarcinoma between 2013 and 2014 were reviewed. Clinicopathologic characteristics of these patients were assessed in the Cox proportional hazards regression model. Brain metastasis occurred in 12 patients (11.6%). On univariate analysis, N2 stage (P = 0.013), stage III (P = 0.016), increased CEA level (P = 0.006), and higher PLR value (P = 0.020) before treatment were associated with an increased risk of developing brain metastasis. In multivariate model analysis, CEA above 5.2 ng/mL (P = 0.014) and PLR ≥ 120 (P = 0.036) remained as the risk factors for brain metastasis. The combination of CEA and PLR was superior to CEA or PLR alone in predicting brain metastasis according to the receiver operating characteristic (ROC) curve analysis (area under ROC curve, AUC 0.872 versus 0.784 versus 0.704). Pretreatment CEA and PLR are independent and significant risk factors for occurrence of brain metastasis in resected lung adenocarcinoma patients. Combining these two factors may improve the predictability of brain metastasis.

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The combination of fibrinogen concentrations and the platelet-to-lymphocyte ratio predicts survival in patients with advanced lung adenocarcinoma treated with EGFR-TKIs

Journal of International Medical Research ◽

10.1177/03000605211004021 ◽

2021 ◽

Vol 49 (4) ◽

pp. 030006052110040

Author(s):

Qiong He ◽

Yamin Li ◽

Xihong Zhou ◽

Wen Zhou ◽

Chunfang Xia ◽

...

Keyword(s):

Lung Adenocarcinoma ◽

Kinase Inhibitors ◽

Characteristic Curve ◽

Performance Status ◽

Univariate Analysis ◽

Progression Free Survival ◽

Platelet To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Egfr Mutant ◽

Egfr Tkis

Objective This study aimed to identify a predictive marker of response to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) in patients with EGFR-mutant advanced lung adenocarcinoma. Methods A cohort of 190 patients with EGFR-mutant advanced lung adenocarcinoma was analyzed. Receiver operating characteristic curve analysis was used to evaluate the optimal cutoffs for fibrinogen levels, the neutrophil-to-lymphocyte ratio (NLR), and the platelet-to-lymphocyte ratio (PLR) for predicting progression-free survival (PFS). Univariate and multivariate survival analyses were performed to identify factors correlated with PFS and overall survival (OS). Results High NLR was associated with worse performance status. In univariate analysis, fibrinogen levels, NLR, and PLR were correlated with OS and PFS. In multivariate analysis, all three variables remained predictive of OS, whereas only fibrinogen levels and PLR were independent prognostic factors for PFS. Furthermore, the combination of fibrinogen levels and PLR (F-PLR score) could stratify patients into three groups with significantly different prognoses, and the score was independently predictive of survival. Conclusion The F-PLR score predicted the prognosis of patients with EGFR-mutant advanced lung adenocarcinoma who received EGFR-TKIs, and this score may serve as a convenient blood-based marker for identifying high-risk patients.

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Association of Derived Neutrophil-To-Lymphocyte Ratio With Prognosis of Coronary Heart Disease After PCI

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.705862 ◽

2021 ◽

Vol 8 ◽

Author(s):

Gang-Qiong Liu ◽

Wen-Jing Zhang ◽

Jia-Hong Shangguan ◽

Xiao-Dan Zhu ◽

Wei Wang ◽

...

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Cox Regression ◽

Univariate Analysis ◽

Neutrophil To Lymphocyte Ratio ◽

Major Adverse Cardiovascular Events ◽

Lymphocyte Ratio ◽

Coronary Syndrome ◽

The Third

Aims: The present study aimed to investigate the prognostic role of derived neutrophil-to-lymphocyte ratio (dNLR) in patients with coronary heart disease (CHD) after PCI.Methods: A total of 3,561 post-PCI patients with CHD were retrospectively enrolled in the CORFCHD-ZZ study from January 2013 to December 2017. The patients (3,462) were divided into three groups according to dNLR tertiles: the first tertile (dNLR < 1.36; n = 1,139), second tertile (1.36 ≥ dNLR < 1.96; n = 1,166), and third tertile(dNLR ≥ 1.96; n = 1,157). The mean follow-up time was 37.59 ± 22.24 months. The primary endpoint was defined as mortality (including all-cause death and cardiac death), and the secondary endpoint was major adverse cardiovascular events (MACEs) and major adverse cardiovascular and cerebrovascular events (MACCEs).Results: There were 2,644 patients with acute coronary syndrome (ACS) and 838 patients with chronic coronary syndrome (CCS) in the present study. In the total population, the all-cause mortality (ACM) and cardiac mortality (CM) incidence was significantly higher in the third tertile than in the first tertile [hazard risk (HR) = 1.8 (95% CI: 1.2–2.8), p = 0.006 and HR = 2.1 (95% CI: 1.23–3.8), p = 0.009, respectively]. Multivariate Cox regression analyses suggested that compared with the patients in the first tertile than those in the third tertile, the risk of ACM was increased 1.763 times (HR = 1.763, 95% CI: 1.133–2.743, p = 0.012), and the risk of CM was increased 1.763 times (HR = 1.961, 95% CI: 1.083–3.550, p = 0.026) in the higher dNLR group during the long-term follow-up. In both ACS patients and CCS patients, there were significant differences among the three groups in the incidence of ACM in univariate analysis. We also found that the incidence of CM was significantly different among the three groups in CCS patients in both univariate analysis (HR = 3.541, 95% CI: 1.154–10.863, p = 0.027) and multivariate analysis (HR = 3.136, 95% CI: 1.015–9.690, p = 0.047).Conclusion: The present study suggested that dNLR is an independent and novel predictor of mortality in CHD patients who underwent PCI.

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Absolute Lymphocyte Count, Platelet-to-Lymphocyte Ratio, and Overall Survival in Eribulin-treated HER2-negative Metastatic Breast Cancer Patients

Cancer Diagnosis & Prognosis ◽

10.21873/cdp.10058 ◽

2021 ◽

Vol 1 (5) ◽

pp. 435-441

Author(s):

YOICHI KOYAMA ◽

SAORI KAWAI ◽

NATSUKI UENAKA ◽

MIKI OKAZAKI ◽

MARIKO ASAOKA ◽

...

Keyword(s):

Breast Cancer ◽

Overall Survival ◽

Cancer Patients ◽

Lymphocyte Count ◽

Univariate Analysis ◽

Metastatic Breast ◽

Absolute Lymphocyte Count ◽

Breast Cancer Patients ◽

Platelet To Lymphocyte Ratio ◽

Lymphocyte Ratio

Background/Aim: To investigate the utility of peripheral blood biomarkers – absolute lymphocyte count (ALC), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) – for predicting outcomes in eribulin-treated patients with metastatic human epidermal growth factor receptor type 2 (HER2)-negative breast cancer. Patients and Methods: ALC, NLR, and PLR were retrospectively obtained from pre-treatment blood sampling results of 120 patients and stratified according to means. Univariate and multivariate analyses were performed to investigate the association of clinicopathological factors, including these values, with overall survival (OS) and progression-free survival (PFS). Results: The ALC, NLR, and PLR cut-off points were 1,285/μl, 3.3, and 235, respectively. No biomarkers were associated with PFS. However, univariate analysis showed ALC (p=0.044) and PLR (p=0.044) to be significantly associated with OS. Conclusion: ALC and PLR can predict eribulin efficacy in terms of OS, reflecting the antitumour immune response in the microenvironment and indicating eribulin’s effectiveness.

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Endometrioid Carcinoma of the Ovary: A Retrospective Analysis of 106 Cases

Tumori Journal ◽

10.1177/030089169808400508 ◽

1998 ◽

Vol 84 (5) ◽

pp. 552-557 ◽

Cited By ~ 16

Author(s):

Giuseppe Grosso ◽

Francesco Raspagliesi ◽

Gabriela Baiocchi ◽

Emanuela Di Re ◽

Maria Colavita ◽

...

Keyword(s):

Residual Disease ◽

Univariate Analysis ◽

Stage Iv ◽

Tumor Grade ◽

Residual Tumor ◽

Figo Stage ◽

Lymph Node Status ◽

Endometrioid Carcinoma ◽

Synchronous Tumors ◽

Carcinoma Of The Ovary

Aims and background This report retrospectively analyzes 106 cases of endometrioid carcinoma of the ovary treated at the National Cancer Institute of Milan from 1974 through December 1993. In 12 of the 106 cases (11.3%) a synchronous carcinoma of the uterine body was observed. Methods and study design Only patients who had previously untreated disease were included in the study. Patients with synchronous tumors were staged according to their ovarian cancer and treated according to the stage of that disease. Results Thirty-nine patients (36.8%) had stage I, 17 (16.0%) stage II, 43 (40.6%) stage III, and 7 (6.6%) stage IV disease. Moderately plus poorly differentiated tumors were present in 76 of the 106 cases (71.7%). Considering the 67 patients with advanced disease, residual tumor was absent in 27 cases (40.3%), ≤ 2 cm in 17 (25.4%), and > 2 cm in 23 (34.3%) cases. Systematic pelvic and para-aortic lymphadenectomy was performed in 60 patients (56.6%); selective sampling was carried out in 23 cases (21.7%). After surgery, 77 patients underwent various chemotherapy regimens. Conclusion Using univariate analysis, FIGO stage, tumor grade, residual disease after surgery, lymph node status, and platinum in the chemotherapy regimen significantly influenced 5-year survival. However, when all these variables were included in a multivariate analysis only FIGO stage still had a significant impact on survival. Survival analysis also showed a trend towards longer survival in patients with synchronous tumors.

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