Pretreatment neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios do not predict survival in patients with cervical cancer treated with neoadjuvant chemotherapy and radical hysterectomy

Background A few inflammatory markers were studied to evaluate their possible prognostic roles in various cancers. The neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio are hypothesized to reflect the systemic inflammation. The objective of the present study was to investigate whether or not the pretreatment neutrophil-to-lymphocyte ratio or platelet-to-lymphocyte ratio can predict the survival of patients with cervical cancer treated with neoadjuvant chemotherapy and radical hysterectomy. Methods We performed a retrospective study on cervical cancer patients (FIGO stage Ib2-IIb) who had undergone neoadjuvant chemotherapy and radical hysterectomy at Peking Union Medical College Hospital between January 1999 and December 2010. Data on demographics, clinical prognostic markers and histopathology were collected and analyzed. Univariate and multivariate analyses for prognostic factors were performed. Results A total of 111 patients were identified. The median neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios were 2.4 and 142.2, respectively. Overall survival and progression-free survival were neither significantly different between patients with high and low neutrophil-to-lymphocyte ratio (P=0.149 and P=0.108) nor in high and low platelet-to-lymphocyte ratio (P=0.336 and P=0.510). On multivariate analysis, lymph node status (P=0.000 and P=0.007) and lymphovascular space involvement (P=0.001 and P=0.001) were independent prognostic factors of progression-free survival and overall survival. Conclusions Lymph node status and lymphovascular space involvement were found to be independent prognostic factors for patients with cervical cancer who underwent neoadjuvant chemotherapy and radical hysterectomy. The pretreatment neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios seemed not to predict the survival of patients with cervical cancer treated with neoadjuvant chemotherapy and radical hysterectomy.