Introduction/Background This study aims to determine the association of hematological indices like Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Albumin Globulin Ratio (AGR) with Overall Survival (OS) in cervical cancer patients treated with Concurrent Chemo-Radiotherapy (CCRT).

Methodology This study was conducted retrospectively between January 2016 till December 2019 in Amrita Institute of Medical Sciences. Patients with any stage who received definitive radiotherapy and/or chemotherapy and followed up-to at least 2 years post treatment were included. Receiver Operating Characteristic curves were used to determine the cut-off values for hematological indices. Kaplan-Meier analysis was done to calculate Overall Survival (OS), Progression-Free survival (PFS) and Recurrence-Free Survival (RFS).

Results A total of 123 patients were included. Mean age was 68 years. Majority of the patients presented with stage IIB (n=48, 39%). Squamous cell histology was seen in 94 patients (76.4%). Ninety-nine patients (81.4%) were treated with CCRT and 24 patients (19.6%) with only RT. Seven patients (5.6%) had disease progression and 17 patients (13.8%) experienced recurrences. With a median follow-up of 56 months, 5-year OS was 67.3 months, PFS was 84.8 months and RFS was 77.8 months. AGR (p = 0.001), NLR (p = 0.0001) and PLR (p = 0.001) were found significantly associated with OS, NLR (p= 0.002) and AGR (p = 0.001) significantly affected RFS while only PLR (p = 0.02) significantly affected PFS on univariate analysis. NLR significantly impacted OS (p = 0.003) and RFS (p = 0.03) on multi-variate analysis.

Conclusion This study reflects that NLR has a profound effect on the prognosis of cervical cancer patients treated with CCRT. Thus, pre-treatment hematological indices may be used as predictive markers for determining clinical outcomes in cervical cancer patients planned for upfront CCRT.

Disclosures None.