%0 Journal Article %A Claudia Marchetti %A Alessia Romito %A Angela Musella %A Giulia Santo %A Innocenza Palaia %A Giorgia Perniola %A Violante Di Donato %A Ludovico Muzii %A Pierluigi Benedetti Panici %T Combined Plasma Fibrinogen and Neutrophil Lymphocyte Ratio in Ovarian Cancer Prognosis May Play a Role? %D 2018 %R 10.1097/IGC.0000000000001233 %J International Journal of Gynecologic Cancer %P 939-944 %V 28 %N 5 %X 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. %U https://ijgc.bmj.com/content/ijgc/28/5/939.full.pdf