Prognostic Implication of Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) in Carcinoma Cervix Patients

Sulagna  Mohanty; Smita  Priyadarshinee; Biswa Ranjan  Routroy

Authors

Sulagna Mohanty Assistant Professor, Department of Radiation Oncology, AHPGIC, Cuttack, Odisha, India
Smita Priyadarshinee Senior resident, Department of Radiation oncology, AHPGIC, Cuttack, Odisha
Biswa Ranjan Routroy Associate Professor, Department of Radiation Oncology, VIMSAR Burla, Odisha

Abstract

Background: In India, cervical cancer continues to be the primary cause of cancer-related death for women, especially in the state of Odisha. Even while molecular markers and advanced imaging are developing, there is a clear need for easily accessible prognostic techniques in settings with limited resources. Hematological markers have emerged as potential indicators of the crucial role that systemic inflammation plays in tumor development and survival, according to recent findings.

Objective: This study's main goal was to ascertain if pre-treatment Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) could function as accurate prognostic indicators for patients with cervical cancer's Overall Survival (OS) and Disease-Free Survival (DFS).

Methods: Using a combination of retrospective and prospective data, we carried out this observational study at the Acharya Harihar Post Graduate Institute of Cancer (AHPGIC), Cuttack, over a three-year period (2021–2024). There were 260 individuals in the trial group, all of whom had cervical cancer verified by histology. We examined complete blood count (CBC) data obtained before to the start of any treatment in order to calculate the NLR and PLR. To determine the best cut-off settings, we employed Receiver Operating Characteristic (ROC) curves. Finally, we used Cox proportional hazards models and Kaplan-Meier survival curves to assess Overall Survival (OS) and Disease-Free Survival (DFS).

Results: The median age of the study group was fifty-two. The ideal cut-off values were found to be 2.85 for NLR and 145.5 for PLR. Larger tumor size, lymph node metastasis (), and advanced FIGO stage () were among the aggressive disease traits significantly associated with elevated levels of both markers. Three-year Overall Survival was significantly poorer in patients with high NLR ( vs. ; ) and high PLR ( vs. ; ). Furthermore, multivariate analysis confirmed that high NLR (;
) and PLR (; ) are independent predictors of lower survival.

Conclusion: For cervical cancer, NLR and PLR are reliable, independent, and easily accessible prognostic indicators. At AHPGIC, stratifying patients according to these inflammatory indicators may aid in identifying high-risk patients in need of more intensive therapy measures.

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