Prognostic significance of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio in uterine carcinosarcoma.

INTRODUCTION

Uterine carcinosarcoma (UCS) and uterine sarcomas (US) are rare but aggressive cancer with poor prognoses. The prognostic value of systemic inflammatory response (SIR) indicators, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR), in predicting outcomes of UCS and US remains unclear. This study investigated the prognostic significance of SIR indicators for UCS and US.

MATERIALS AND METHODS

Clinicopathological data from 237 patients diagnosed with UCS or US across 14 hospitals from January 2008 to December 2017 were retrospectively analyzed. NLR, PLR, and MLR values were calculated from preoperative blood counts. Prognostic impact was evaluated using Kaplan-Meier survival analysis, Cox regression models, and receiver operating characteristic (ROC) curve analysis.

RESULTS

Elevated NLR, PLR, and MLR were associated with poorer progression-free survival (PFS) in UCS. Additionally, a high NLR also indicated worse overall survival (OS) in UCS. In patients with US, only PLR was significantly associated with poorer PFS. Combining SIR indicators provided a stronger prognostic prediction for UCS compared to individual indicators. Multivariate analysis revealed that high levels of SIR indicators were an independent poor prognostic factor for both PFS and OS in UCS.

CONCLUSION

SIR indicators, particularly when combined, are valuable prognostic markers in UCS, reflecting the inflammatory status and aiding in stratifying patients for tailored therapeutic strategies. These findings support the incorporation of SIR indicators into clinical practice for better management of patients with UCS.