The Ratio of Neutrophil to Lymphocyte is a Predictor in Endometrial Cancer.

OBJECTIVE

The aim of our study was to assess the prognostic value of the ratio of neutrophil to lymphocyte (NLR) for patients with surgically treated endometrial cancer (EC).

METHODS

We retrospectively reviewed 510 EC patients who were surgically treated between January 2010 and December 2016. We used receiver-operating characteristic (ROC) curve analysis to identify an optimal cut-off for NLR in predicting overall survival (OS), cancer-specific survival (CSS) and disease-free survival (DFS). Nonparametric tests were used to determine the associations between NLR and clinicopathologic characteristics. The Kaplan-Meier method and Cox proportional-hazards regression were used for survival analysis.

RESULTS

With a cut-off of 2.47, the 510 patients were divided into low NLR (NLR <2.47) and high NLR (NLR ≥2.47). Elevated NLR was associated with advanced stage (P=0.039), increased histology grade (P=0.005) and lymph node metastasis (P=0.041). Multivariable analysis suggested that NLR was an independent prognostic marker for OS (hazard ratio [HR] 4.7; 95% confidence interval [CI], 1.5-14.1; P =0.006), CSS (HR 3.6; 95% CI, 1.1-11.5; P =0.028) and DFS (HR 2.3; 95% CI, 1.0-5.2; P =0.044).

CONCLUSION

NLR may be an independent prognostic indicator for OS, CSS and DFS. It could help clinicians with preoperative risk stratification and treatment strategy tailoring.