Preoperative platelet lymphocyte ratio as an independent prognostic marker in ovarian cancer

Ovarian cancer is associated with high mortality due to presentation at advanced stage and high recurrence following treatment with chemotherapy. Most of the prognostic variables in ovarian cancer, including stage and residual disease, are amenable for assessment only after surgery. Currently there are no established preoperative markers including, CA-125, that can predict overall survival in patients with ovarian cancer. The aim of our study was to evaluate the prognostic significance of the preoperative haematological markers platelet lymphocyte ratio (PLR) and neutrophil lymphocyte ratio (NLR) in patients with ovarian cancer. Preoperative PLR and NLR were evaluated in 235 patients undergoing surgery for ovarian cancer. The prognostic significance of both markers was then determined by both uni- and multivariate analytical methods. High preoperative PLR (p < 0.001) and NLR (p=0.001) were significantly associated with poor survival using univariate Cox survival analysis. The median overall survival in patients with a PLR of < 300 was 37.4 months (95%CI 26.1-48.7) and 14.5 months (95%CI 11.7-17.2) in those with a PLR of > 300. PLR (p=0.03) but not NLR (p=0.575) retained its significance as a prognostic marker on multivariate Cox's regression analysis, along with stage (p < 0.001) and residual disease (p=0.015). We have shown for the first time that PLR is a novel independent prognostic marker in patients with ovarian cancer.