Cancer Res Treat.  2015 Jul;47(3):480-488. 10.4143/crt.2014.058.

Prognostic Significance of Retroperitoneal Lymphadenectomy, Preoperative Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio in Primary Fallopian Tube Carcinoma: A Multicenter Study

Affiliations
  • 1Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey. isaaykutozdemir@hotmail.com
  • 2Department of Gynecologic Oncology, Osmangazi University School of Medicine, Eskisehir, Turkey.
  • 3Department of Gynecologic Oncology, Ankara University School of Medicine, Ankara, Turkey.
  • 4Department of Gynecologic Oncology, Cukurova University School of Medicine, Adana, Turkey.
  • 5Department of Gynecologic Oncology, Ege University School of Medicine, Izmir, Turkey.
  • 6Department of Gynecologic Oncology, Akdeniz University School of Medicine, Antalya, Turkey.

Abstract

PURPOSE
The purpose
of this study is to evaluate the prognostic role of preoperative neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) and the need for para-aortic lymphadectomy in patients with primary fallopian tube carcinoma (PFTC).
MATERIALS AND METHODS
Ninety-one patients with a diagnosis of PFTC were identified through the gynecologic oncology service database of six academic centers. Clinicopathological, surgical, and complete blood count data were collected.
RESULTS
In univariate analysis, advanced stage, suboptimal surgery, and NLR > 2.7 were significant prognostic factors for progression-free survival, whereas in multivariate analysis, only advanced stage and suboptimal surgery were significant. In addition, in univariate analysis, cancer antigen 125 > or = 35 U/mL, ascites, advanced stage, suboptimal surgery, NLR > 2.7, PLR > 233.3, platelet count > or =400,000 cells/mm3, staging type, and histological subtype were significant prognostic factors for overall survival (OS); however, in multivariate analysis, only advanced stage, suboptimal surgery, NLR > 2.7, and staging type were significant. Inclusion of pelvic and para-aortic lymphadenectomy in surgery showed significant association with longer OS, with a mean and median OS of 42.0 months and 35.5 months (range, 22 to 78 months), respectively, vs. 33.5 months and 27.5 months (range, 14 to 76 months), respectively, for patients who underwent surgery without para-aortic lymphadenectomy (hazard ratio, 3.1; 95% confidence interval, 1.4 to 5.7; p=0.002).
CONCLUSION
NLR (in both univariate and multivariate analysis) and PLR (only in univariate analysis) were prognostic factors in PFTC. NLR and PLR are inexpensive and easy tests to perform. In addition, patients with PFTC who underwent bilateral pelvic and para-aortic lymphadenectomy had longer OS.

Keyword

Primary fallopian tube carcinoma; Retroperitoneal lymphadenectomy; Neutrophil lymphocyte ratio; Platelet lymphocyte ratio; Prognostic factor
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