The Role of Preoperative Neutrophil/Lymphocyte, Lymphocyte/Monocyte and Platelet/Lymphocyte Ratios in the Serous Over Cancer Survival
Yıl 2021,
Cilt: 5 Sayı: 1, 43 - 53, 28.02.2021
Serap Durmuşoğlu Erben
,
Fatih Kılıç
,
Mehmet Ünsal
,
Okan Aytekin
Günsu Kimyon Cömert
,
Alper Karalök
,
Osman Türkmen
,
Ömer Lütfi Tapısız
,
Taner Turan
,
Gökhan Tulunay
Öz
Aim: The aim of this study was to evaluate the prognostic value of the preoperative systemic inflammatory markers in patients with serous-type ovarian cancer and to reveal their relationship with survival.
Materials and Methods: Data from 86 serous type ovarian cancer patients were evaluated retrospectively. Neutrophil-lymphocyte (NLR), lymphocyte-monocyte (LMR) and platelet-lymphocyte (PLR) ratios were used as preoperative inflammatory markers. The patients were grouped as high or low risk according to NLR, LMR and PLR values. Median values were used as cut-off values for categorizing groups. The effects of NLR, LMR and PLR values on disease-free survival (DFS) and overall survival (OS) with clinical, surgical and pathological variables were investigated.
Results: The median age of the patients was 58.03 years (range; 25-80). The stage of the disease was found as 12 patients stage I-II and 74 patients stage III-IV. The median follow-up was 29.45 months (range; 1-63), during this period 21 (24.4%) patients developed recurrence and 15 (17.4%) patients died due to the disease. The mean DFS time was 46.32 ± 3.00 months and OS time was 51.30 ± 2.43 months in the whole study group. For DFS; omentum metastasis, splenic metastasis, diaphragmatic metastasis, colon metastasis, surgical outcome and adjuvant treatment success and for OS; omentum metastasis, whether the patient received adjuvant therapy and adjuvant treatment success were found to be significant (p<0.05). No statistically significant relationship was found between NLR-LMR-TLR and OS-DFS data (p>0.05).
Conclusion: It was found that preoperative inflammatory markers could not predict disease-free survival and overall survival in serous type ovarian cancer.
Kaynakça
- 1. Togashi K. Ovarian cancer: the clinical role of US, CT, and MRI. Eur Radiol. 2003;13 Suppl 4:L87-104.
- 2. Robboy SJ. Robboy's pathology of the female reproductive tract: Elsevier Health Sciences. 2009.
- 3. Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature. 2008;454(7203):436-44.
- 4. Condeelis J, Pollard JW. Macrophages: obligate partners for tumor cell migration, invasion, and metastasis. Cell. 2006;124(2):263-6.
- 5. Coussens LM, Werb Z. Inflammation and cancer. Nature. 2002;420(6917):860-7.
- 6. Walsh SR, Cook EJ, Goulder F, Justin TA, Keeling NJ. Neutrophil-lymphocyte ratio as a prognostic factor in colorectal cancer. J Surg Oncol. 2005;91(3):181-4.
- 7. Teng JJ, Zhang J, Zhang TY, Zhang S, Li BS. Prognostic value of peripheral blood lymphocyte-to-monocyte ratio in patients with solid tumors: a meta-analysis. Onco Targets Ther. 2016;9:37-47.
- 8. Raungkaewmanee S, Tangjitgamol S, Manusirivithaya S, Srijaipracharoen S, Thavaramara T. Platelet to lymphocyte ratio as a prognostic factor for epithelial ovarian cancer. J Gynecol Oncol. 2012;23(4):265-73.
- 9. Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation. Cell. 2011;144(5):646-74.
- 10. Takahashi R, Mabuchi S, Kawano M, Sasano T, Matsumoto Y, Kuroda H, et al. Prognostic significance of systemic neutrophil and leukocyte alterations in surgically treated endometrial cancer patients: a monoinstitutional study. Gynecol Oncol. 2015;137(1):112-8.
- 11. Organization WH. WHO handbook for reporting results of cancer treatment: World Health Organization; 1979.
- 12. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424.
- 13. Torre LA, Trabert B, DeSantis CE, Miller KD, Samimi G, Runowicz CD, et al. Ovarian cancer statistics, 2018. CA Cancer J Clin. 2018;68(4):284-96.
- 14. Azuma T, Matayoshi Y, Odani K, Sato Y, Sato Y, Nagase Y, et al. Preoperative neutrophil-lymphocyte ratio as an independent prognostic marker for patients with upper urinary tract urothelial carcinoma. Clin Genitourin Cancer. 2013;11(3):337-41.
- 15. Teramukai S, Kitano T, Kishida Y, Kawahara M, Kubota K, Komuta K, et al. Pretreatment neutrophil count as an independent prognostic factor in advanced non-small-cell lung cancer: an analysis of Japan Multinational Trial Organisation LC00-03. Eur J Cancer. 2009;45(11):1950-8.
- 16. Schmidt H, Bastholt L, Geertsen P, Christensen IJ, Larsen S, Gehl J, et al. Elevated neutrophil and monocyte counts in peripheral blood are associated with poor survival in patients with metastatic melanoma: a prognostic model. Br J Cancer. 2005;93(3):273-8.
- 17. Bishara S, Griffin M, Cargill A, Bali A, Gore ME, Kaye SB, et al. Pre-treatment white blood cell subtypes as prognostic indicators in ovarian cancer. Eur J Obstet Gynecol Reprod Biol. 2008;138(1):71-5.
- 18. Lee YY, Choi CH, Sung CO, Do IG, Huh S, Song T, et al. Prognostic value of pre-treatment circulating monocyte count in patients with cervical cancer: comparison with SCC-Ag level. Gynecol Oncol. 2012;124(1):92-7.
19. Cho H, Hur HW, Kim SW, Kim SH, Kim JH, Kim YT, et al. Pre-treatment neutrophil to lymphocyte ratio is elevated in epithelial ovarian cancer and predicts survival after treatment. Cancer Immunol Immunother. 2009;58(1):15-23.
- 20. Williams KA, Labidi-Galy SI, Terry KL, Vitonis AF, Welch WR, Goodman A, et al. Prognostic significance and predictors of the neutrophil-to-lymphocyte ratio in ovarian cancer. Gynecol Oncol. 2014;132(3):542-50.
- 21. Digklia A, Voutsadakis IA. Thrombocytosis as a prognostic marker in stage III and IV serous ovarian cancer. Obstet Gynecol Sci. 2014;57(6):457-63.
- 22. Stravodimou A, Voutsadakis IA. Pretreatment thrombocytosis as a prognostic factor in metastatic breast cancer. Int J Breast Cancer. 2013;2013:289563.
- 23. Shimada H, Oohira G, Okazumi S, Matsubara H, Nabeya Y, Hayashi H, et al. Thrombocytosis associated with poor prognosis in patients with esophageal carcinoma. J Am Coll Surg. 2004;198(5):737-41.
- 24. Hernandez E, Lavine M, Dunton CJ, Gracely E, Parker J. Poor prognosis associated with thrombocytosis in patients with cervical cancer. Cancer. 1992;69(12):2975-7.
- 25. Asher V, Lee J, Innamaa A, Bali A. Preoperative platelet lymphocyte ratio as an independent prognostic marker in ovarian cancer. Clin Transl Oncol. 2011;13(7):499-503.
- 26. Bruckner HW, Lavin PT, Plaxe SC, Storch JA, Livstone EM. Absolute granulocyte, lymphocyte, and moncyte counts. Useful determinants of prognosis for patients with metastatic cancer of the stomach. JAMA. 1982;247(7):1004-6.
- 27. Hu P, Shen H, Wang G, Zhang P, Liu Q, Du J. Prognostic significance of systemic inflammation-based lymphocyte- monocyte ratio in patients with lung cancer: based on a large cohort study. PLoS One. 2014;9(9):e108062.
- 28. Szkandera J, Gerger A, Liegl-Atzwanger B, Absenger G, Stotz M, Friesenbichler J, et al. The lymphocyte/monocyte ratio predicts poor clinical outcome and improves the predictive accuracy in patients with soft tissue sarcomas. Int J Cancer. 2014;135(2):362-70.
- 29. Stotz M, Pichler M, Absenger G, Szkandera J, Arminger F, Schaberl-Moser R, et al. The preoperative lymphocyte to monocyte ratio predicts clinical outcome in patients with stage III colon cancer. Br J Cancer. 2014;110(2):435-40.
Preoperatif Nötrofil/Lenfosit, Lenfosit/Monosit ve Trombosit/Lenfosit Oranlarının Seröz Over Kanseri Sağ Kalımındaki Yeri
Yıl 2021,
Cilt: 5 Sayı: 1, 43 - 53, 28.02.2021
Serap Durmuşoğlu Erben
,
Fatih Kılıç
,
Mehmet Ünsal
,
Okan Aytekin
Günsu Kimyon Cömert
,
Alper Karalök
,
Osman Türkmen
,
Ömer Lütfi Tapısız
,
Taner Turan
,
Gökhan Tulunay
Öz
Amaç: Seröz tip over kanserinde preoperatif sistemik inflamatuar belirteçlerin prognozu predikte etmedeki etkinliğini değerlendirmek ve sağ kalım ile ilişkilerini tanımlamak amaçlandı.
Gereç ve Yöntemler: Çalışma grubu seröz tip over kanseri nedeniyle tedavisi yapılan 86 hastadan oluşturuldu. Hastalara ait veriler retrospektif olarak tarandı. Preoperatif inflamatuar belirteçler olarak nötrofil/lenfosit oranı (NLO), lenfosit/monosit oranı (LMO) ve trombosit/lenfosit oranları (TLO) kullanıldı. Hastalar NLO, LMO ve TLO değerlerine göre yüksek veya düşük riskli olarak gruplandırıldı. Grupları kategorize etmede sınır değer olarak ortanca değerler kullanıldı. Klinik, cerrahi ve patolojik değişkenlerle birlikte NLO, LMO, TLO değerlerinin hastalıksız sağ kalım (HSK) ve genel sağ kalım (GSK) üzerindeki etkisi incelendi.
Bulgular: Hastaların ortanca yaşları 58.03 (aralık; 25-80) yıldı. Evre 12 hastada evre I-II ve 74 hastada evre III-IV’tü. Ortanca takip süresi 29.45 aydı (aralık; 1-63) ve bu süre içerisinde 21 (%24,4) hastada rekürrens geliştiği ve 15 (%17,4) hastanın hastalıktan dolayı öldüğü tespit edildi. Tüm çalışma grubunda ortalama HSK süresi 46.32±3,00 ay ve GSK süresi 51.30±2.43 aydı. HSK için; omentum metastazı, dalak metastazı, diyafragma metastazı, kolon metastazı, cerrahi sonuç ve adjuvant tedavi başarısı, GSK için; omentum metastazı, hastanın adjuvant tedavi alıp almaması ve adjuvan tedavi başarısı anlamlıydı (p<0.05). NLO-LMO-TLO ile GSK ve HSK verileri arasında istatistiksel olarak anlamlı bir ilişki saptanmadı (p>0.05).
Sonuç: Seröz tip over kanserinde, preoperatif inflamatuar belirteçlerin hastalıksız sağ kalımı ve genel sağ kalımı öngörmede yönlendirici olmadığı tespit edilmiştir.
Kaynakça
- 1. Togashi K. Ovarian cancer: the clinical role of US, CT, and MRI. Eur Radiol. 2003;13 Suppl 4:L87-104.
- 2. Robboy SJ. Robboy's pathology of the female reproductive tract: Elsevier Health Sciences. 2009.
- 3. Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature. 2008;454(7203):436-44.
- 4. Condeelis J, Pollard JW. Macrophages: obligate partners for tumor cell migration, invasion, and metastasis. Cell. 2006;124(2):263-6.
- 5. Coussens LM, Werb Z. Inflammation and cancer. Nature. 2002;420(6917):860-7.
- 6. Walsh SR, Cook EJ, Goulder F, Justin TA, Keeling NJ. Neutrophil-lymphocyte ratio as a prognostic factor in colorectal cancer. J Surg Oncol. 2005;91(3):181-4.
- 7. Teng JJ, Zhang J, Zhang TY, Zhang S, Li BS. Prognostic value of peripheral blood lymphocyte-to-monocyte ratio in patients with solid tumors: a meta-analysis. Onco Targets Ther. 2016;9:37-47.
- 8. Raungkaewmanee S, Tangjitgamol S, Manusirivithaya S, Srijaipracharoen S, Thavaramara T. Platelet to lymphocyte ratio as a prognostic factor for epithelial ovarian cancer. J Gynecol Oncol. 2012;23(4):265-73.
- 9. Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation. Cell. 2011;144(5):646-74.
- 10. Takahashi R, Mabuchi S, Kawano M, Sasano T, Matsumoto Y, Kuroda H, et al. Prognostic significance of systemic neutrophil and leukocyte alterations in surgically treated endometrial cancer patients: a monoinstitutional study. Gynecol Oncol. 2015;137(1):112-8.
- 11. Organization WH. WHO handbook for reporting results of cancer treatment: World Health Organization; 1979.
- 12. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424.
- 13. Torre LA, Trabert B, DeSantis CE, Miller KD, Samimi G, Runowicz CD, et al. Ovarian cancer statistics, 2018. CA Cancer J Clin. 2018;68(4):284-96.
- 14. Azuma T, Matayoshi Y, Odani K, Sato Y, Sato Y, Nagase Y, et al. Preoperative neutrophil-lymphocyte ratio as an independent prognostic marker for patients with upper urinary tract urothelial carcinoma. Clin Genitourin Cancer. 2013;11(3):337-41.
- 15. Teramukai S, Kitano T, Kishida Y, Kawahara M, Kubota K, Komuta K, et al. Pretreatment neutrophil count as an independent prognostic factor in advanced non-small-cell lung cancer: an analysis of Japan Multinational Trial Organisation LC00-03. Eur J Cancer. 2009;45(11):1950-8.
- 16. Schmidt H, Bastholt L, Geertsen P, Christensen IJ, Larsen S, Gehl J, et al. Elevated neutrophil and monocyte counts in peripheral blood are associated with poor survival in patients with metastatic melanoma: a prognostic model. Br J Cancer. 2005;93(3):273-8.
- 17. Bishara S, Griffin M, Cargill A, Bali A, Gore ME, Kaye SB, et al. Pre-treatment white blood cell subtypes as prognostic indicators in ovarian cancer. Eur J Obstet Gynecol Reprod Biol. 2008;138(1):71-5.
- 18. Lee YY, Choi CH, Sung CO, Do IG, Huh S, Song T, et al. Prognostic value of pre-treatment circulating monocyte count in patients with cervical cancer: comparison with SCC-Ag level. Gynecol Oncol. 2012;124(1):92-7.
19. Cho H, Hur HW, Kim SW, Kim SH, Kim JH, Kim YT, et al. Pre-treatment neutrophil to lymphocyte ratio is elevated in epithelial ovarian cancer and predicts survival after treatment. Cancer Immunol Immunother. 2009;58(1):15-23.
- 20. Williams KA, Labidi-Galy SI, Terry KL, Vitonis AF, Welch WR, Goodman A, et al. Prognostic significance and predictors of the neutrophil-to-lymphocyte ratio in ovarian cancer. Gynecol Oncol. 2014;132(3):542-50.
- 21. Digklia A, Voutsadakis IA. Thrombocytosis as a prognostic marker in stage III and IV serous ovarian cancer. Obstet Gynecol Sci. 2014;57(6):457-63.
- 22. Stravodimou A, Voutsadakis IA. Pretreatment thrombocytosis as a prognostic factor in metastatic breast cancer. Int J Breast Cancer. 2013;2013:289563.
- 23. Shimada H, Oohira G, Okazumi S, Matsubara H, Nabeya Y, Hayashi H, et al. Thrombocytosis associated with poor prognosis in patients with esophageal carcinoma. J Am Coll Surg. 2004;198(5):737-41.
- 24. Hernandez E, Lavine M, Dunton CJ, Gracely E, Parker J. Poor prognosis associated with thrombocytosis in patients with cervical cancer. Cancer. 1992;69(12):2975-7.
- 25. Asher V, Lee J, Innamaa A, Bali A. Preoperative platelet lymphocyte ratio as an independent prognostic marker in ovarian cancer. Clin Transl Oncol. 2011;13(7):499-503.
- 26. Bruckner HW, Lavin PT, Plaxe SC, Storch JA, Livstone EM. Absolute granulocyte, lymphocyte, and moncyte counts. Useful determinants of prognosis for patients with metastatic cancer of the stomach. JAMA. 1982;247(7):1004-6.
- 27. Hu P, Shen H, Wang G, Zhang P, Liu Q, Du J. Prognostic significance of systemic inflammation-based lymphocyte- monocyte ratio in patients with lung cancer: based on a large cohort study. PLoS One. 2014;9(9):e108062.
- 28. Szkandera J, Gerger A, Liegl-Atzwanger B, Absenger G, Stotz M, Friesenbichler J, et al. The lymphocyte/monocyte ratio predicts poor clinical outcome and improves the predictive accuracy in patients with soft tissue sarcomas. Int J Cancer. 2014;135(2):362-70.
- 29. Stotz M, Pichler M, Absenger G, Szkandera J, Arminger F, Schaberl-Moser R, et al. The preoperative lymphocyte to monocyte ratio predicts clinical outcome in patients with stage III colon cancer. Br J Cancer. 2014;110(2):435-40.