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Prediction scoring system based on clinicohematologic parameters for cervical cancer patients undergoing chemoradiation
  1. Youn Ji Kim1,
  2. Young Saing Kim2,
  3. Jin Woo Shin3,
  4. Biche Osong4 and
  5. Seok Ho Lee5
  1. 1 Gachon University College of Medicine, Incheon, Republic of Korea
  2. 2 Division of Medical Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
  3. 3 Department of Obstetrics and Gynecology, Gachon University Gil Medical Center, Incheon, Republic of Korea
  4. 4 Department of Radiation Oncology (Maastro), GROW School for Oncology, Maastricht University Medical Centre+, Maastricht, The Netherlands
  5. 5 Department of Radiation Oncology, Gachon University Gil Medical Center, Incheon, Republic of Korea
  1. Correspondence to Professor Seok Ho Lee, Radiation Oncology, Gachon University Gil Medical Center, Incheon 405-758, Republic of Korea; souko{at}


Objective A scoring system based on clinicohematologic parameters in cervical cancer patients receiving chemoradiation has not been reported to date. The aim of this study was to determine the prognostic value of clinicohematologic parameters in patients with cervical cancer undergoing chemoradiation and to develop a prediction scoring system based on these results.

Methods A total of 107 patients who received definitive chemoradiation for cervical cancer were enrolled in this study. The clinical data and hematologic parameters were retrospectively reviewed, and their prognostic value in predicting survival was analyzed. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) and the changes in these hematologic parameters (ΔNLR, ΔPLR, and ΔLMR) between pre- and post-treatment were calculated to determine the specific value of these parameters for predicting patient survival.

Results The median follow-up time was 39.9 (range 2.7–114.6) months. The 3-year overall survival rate and progression-free survival rate were 80.9% (95% CI 72.7 to 90.0) and 53.4% (95% CI 44.1 to 64.8), respectively. The median progression-free survival was 67.5 months and the median overall survival was not reached. According to multivariable analysis, a ΔNLR≥0 was significantly associated with decreased progression-free survival (HR=2.91, 95% CI 1.43 to 5.94) and overall survival (HR=3.13, 95% CI 1.18 to 8.27). In addition, age (age <58.5 years; progression-free survival: HR=2.55, 95% CI 1.38 to 4.70; overall survival: HR=4.49, 95% CI 1.78 to 11.33) and the International Federation of Gynecology and Obstetrics (FIGO) stage (Ⅲ-Ⅳ; progression-free survival: HR=2.49, 95% CI 1.40 to 4.43; overall survival: HR=3.02, 95% CI 1.32 to 6.90) were identified as predictors of poor survival.

Conclusions Both the age and FIGO stage, as clinical parameters, and the ΔNLR, as a hematologic parameter, were independent prognostic factors for survival for cervical cancer patients treated with chemoradiation. Based on these results, we developed a risk score-based classification system for predicting survival.

  • cervical cancer
  • radiotherapy

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  • Contributors SHL and YJK designed the research, the main conceptual ideas, and proof outline. YJK contributed to the data collection. SHL, YJK, and BO carried out the statistical analysis. YSK, JWS, and BO contributed to the interpretation of the results of the statistical analysis. YJK and SHL contributed to the writing of the manuscript. All authors discussed the results and commented on the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. According to the journal guidelines, we will provide our share of the data for the reproducibility of this study in other centers.