Combined Plasma Fibrinogen and Neutrophil Lymphocyte Ratio in Ovarian Cancer Prognosis May Play a Role?. Issue 5 (1st June 2018)

• Record Type: Journal Article
• Authors: Marchetti, Claudia; Romito, Alessia; Musella, Angela; Santo, Giulia; Palaia, Innocenza; Perniola, Giorgia; Di Donato, Violante; Muzii, Ludovico; Benedetti Panici, Pierluigi
• Is Part Of: International journal of gynecological cancer. Volume 28:Issue 5(2018)
• Page Start: 939
• Page End: 944
• Publication Date: 2018-06-01
• Subjects: Fibrinogen -- Neutrophil-to-lymphocyte ratio -- Ovarian cancer -- Prognosis; Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1097/IGC.0000000000001233
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Objectives: In ovarian cancer (OC), approximately 70% will relapse within 12 months from diagnosis; inflammation plays an important role in cancer initiating and progression; thus, a combination of neutrophil-to-lymphocyte ratio (NLR) and fibrinogen (F-NLR) has been proposed as prognostic marker in several tumors. The aim of our study was to investigate the correlation between NLR, fibrinogen, and F-NLR and survival in OC population. Methods: Patients with diagnosis of OC admitted to our institute between 2011 and 2016 were included. Data about pretreatment complete blood count were collected. Neutrophil-to-lymphocyte ratio was defined as the absolute neutrophil count divided by the absolute lymphocyte count; the F-NLR score was 0 for low NLR and fibrinogen, 1 for low NLR and high fibrinogen, or, conversely, 2 for both high markers. We correlated this index with progression-free survival. Results: A total of 94 patients were enrolled. Median age at diagnosis was 55 (34–83) years; more than 80% of patients presented International Federation of Gynecology and Obstetrics stage III–IV at diagnosis, and 72 (77%) presented high-grade serous histology. Primary debulking surgery was performed in 57 women (60%), whereas 37 (40%) underwent interval debulking surgery. Mean serum NLR was 5.25 ± 5.37, and mean serum fibrinogen value was 4.19 ± 0.97 g/L. The median follow-up time was 27 months (range, 8–60 months). All patients with F-NLR value of 2 presented advanced disease compared with 64% of those with F-NLR of 0 ( P < 0.031); these patients more frequently required neoadjuvant chemotherapy ( P < 0.003) and more often had platinum-resistant disease ( P < 0.022). Patients with high F-NLR presented worse progression-free survival than did patients with low F-NLR (12 vs 42 months, respectively, P = 0.023). Conclusions: Combining NLR and fibrinogen levels could be used as a factor for prediction of prognosis and response to treatment in patients affected with OC.