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Abstract
Introduction/Background In gynecologic cancer some hematologic indices have been evaluated for their prognostic value: thrombocytosis, platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR), and were found positive inconsistently to overall survival (OS). We examine their predictive value in advanced serous ovarian carcinoma patients treated by neoadjuvant chemotherapy (NACT).
Through the treatment, the pathologic chemotherapy response score (CRS), examined on the omental specimen in the interval debulking surgery, have been validated as an OS prognostic factor. The inspection of tumor- macrophages infiltration characterizing the higher score CRS specimens (CRS3) led to the investigation of the relationship between hematologic indices at diagnosis, and the CRS achieved in the surgery.
Methodology Retrospectively from 2016 to 2022, at a single center, data regarding cases diagnosed with advanced serous ovarian carcinoma, who were referred to NACT and underwent surgery, were extracted from electronic records and analyzed statistically.
Results 116 women were included, and divided into three groups of CRS: 1, 2 and 3, there were no differences in their characteristics: age, primary tumor site, stage, preoperative bevacizumab administration or BRCA status mutation (table 1): OS and PFS were found significant in CRS 1+2 vs CRS 3, median time 53.9 vs. 71.6 months to OS, and 15.2 vs. 51.33 median time to PFS; (p=0.003) and (p<0.001) respectively (figure 1). NRL and monocytes% at diagnosis were found prognostic variables to OS with HR: 1.17, 0.859; (p<0.001) respectively (figure 2). PLR and Platelets count were not found significant.
NLR and monocytes% distribution was not significantly different in the CRS groups, still independently CRS and NLR and monocytes% predicted OS according to COX regression model.
Conclusion NLR and monocytes% as pretreatment indices may play a role in the interaction of the tumor cells and the immune system cells, still their effect is not mediated by CRS, and affect prognosis independently.
Disclosures Authors have no conflict of interest to declare