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Preoperative platelet/lymphocyte ratio is a superior prognostic factor compared to other systemic inflammatory response markers in ovarian cancer patients

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Tumor Biology

Abstract

The aim of the present study was to determine the most meaningful preoperative prognostic factor of cancer-related death in ovarian cancer patients by comparing potentially prognostic systemic inflammatory response (SIR) markers. The levels of fibrinogen, albumin, C-reactive protein (CRP), and serum cancer antigen-125 (CA-125) and the neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) were evaluated in 190 ovarian cancer patients to identify predictors of overall survival (OS) and progression-free survival (PFS) using univariate and multivariate analyses. Patients with a PLR >203 had a shorter PFS and OS than the patients in PLR ≤203 group (11 vs. 24 months and 28 vs. 64 months). Univariate analyses revealed that tumor stage, postoperative residual tumor mass, ascites, and the levels of all SIR markers were associated with PFS and OS. Multivariate analysis revealed that PLR was independently associated with PFS (hazard ratio [HR] 1.852, 95 % confidence interval [CI] 1.271–2.697, P = 0.001) and OS (HR 2.158, 95 %CI 1.468–3.171, P < 0.001), as well as tumor stage and postoperative residual tumor mass. In contrast, fibrinogen remained significant only for PFS (HR 1.724, 95 %CI 1.197–2.482, P = 0.003). Patients with a PLR >203 were more prone to have advanced tumor stage (P = 0.002), postoperative residual tumor mass >2 cm (P = 0.032), malignant ascites (P < 0.001), and all the other elevated SIR markers (P < 0.001). Preoperative PLR is superior to other SIR markers (CA-125, NLR, fibrinogen, CRP, and albumin) as a predictor of survival in ovarian cancer patients.

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Acknowledgments

Wei-wei Zhang and Ke-jun Liu contributed equally to this work. The authors would like to thank doctors, nurses, patients, and their family members for their kindness to support our study.

Grant support

The Department of the Science and Technology Planning Project Fund of Guangdong Province in China (2011B031800042).

Conflicts of interest

None

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Authors and Affiliations

  1. Department of Medical Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China

    Wei-wei Zhang, Guo-lin Hu & Wei-jiang Liang

  2. Department of Medical Oncology, The Sixth People’s Hospital of Chengdu, Chengdu, 610051, China

    Wei-wei Zhang

  3. Department of Medical Oncology, Dongguan People’s Hospital, Dongguan, 523059, China

    Ke-jun Liu

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  1. Wei-wei Zhang
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Correspondence to Wei-jiang Liang.

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Zhang, Ww., Liu, Kj., Hu, Gl. et al. Preoperative platelet/lymphocyte ratio is a superior prognostic factor compared to other systemic inflammatory response markers in ovarian cancer patients. Tumor Biol. 36, 8831–8837 (2015). https://doi.org/10.1007/s13277-015-3533-9

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  • DOI: https://doi.org/10.1007/s13277-015-3533-9

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