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

Azusa Sakurai¹, Ken Yamaguchi², Kentaro Ishida^{1

3}, Naoki Horikawa^{4

5}, Eri Kawai⁶, Yasushi Kotani⁷, Takaaki Yoshida⁸, Naoya Kishimoto⁹, Keiji Tatsumi¹⁰, Minami Okudate¹¹, Yoko Iemura¹², Yukiko Taga¹³, Megumi Aki¹³, Yukiko Ando¹⁴, Akihiro Yanai¹, Koji Yamanoi¹, Mana Taki¹, Ryusuke Murakami¹, Junzo Hamanishi¹, Masaki Mandai¹

Affiliations

¹ Department of Gynecology and Obstetrics, Graduate School of Medicine and Faculty of Medicine, Kyoto University, 54 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan.
² Department of Gynecology and Obstetrics, Graduate School of Medicine and Faculty of Medicine, Kyoto University, 54 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan. soulken@kuhp.kyoto-u.ac.jp.
³ Department of Obstetrics and Gynecology, Osaka Red Cross Hospital, Osaka, Japan.
⁴ Department of Obstetrics and Gynecology, Kurashiki Central Hospital, Okayama, Japan.
⁵ Department of Obstetrics and Gynecology, Shizuoka General Hospital, Shizuoka, Japan.
⁶ Department of Obstetrics and Gynecology, Medical Research Institute Kitano Hospital, Osaka, Japan.
⁷ Department of Obstetrics and Gynecology, Faculty of Medicine, Kindai University, Osaka, Japan.
⁸ Department of Obstetrics and Gynecology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan.
⁹ Department of Obstetrics and Gynecology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
¹⁰ Department of Obstetrics and Gynecology, National Hospital Organization Osaka National Hospital, Osaka, Japan.
¹¹ Department of Obstetrics and Gynecology, Kobe City Medical Center General Hospital, Hyogo, Japan.
¹² Department of Obstetrics and Gynecology, Japanese Red Cross Otsu Hospital, Shiga, Japan.
¹³ Department of Obstetrics and Gynecology, Shiga General Hospital, Shiga, Japan.
¹⁴ Department of Obstetrics and Gynecology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan.

PMID: 39779654
DOI: 10.1007/s10147-024-02687-w

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

Azusa Sakurai et al. Int J Clin Oncol. 2025 Mar.

. 2025 Mar;30(3):570-583.

doi: 10.1007/s10147-024-02687-w. Epub 2025 Jan 8.

Authors

Affiliations

¹ Department of Gynecology and Obstetrics, Graduate School of Medicine and Faculty of Medicine, Kyoto University, 54 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan.
² Department of Gynecology and Obstetrics, Graduate School of Medicine and Faculty of Medicine, Kyoto University, 54 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan. soulken@kuhp.kyoto-u.ac.jp.
³ Department of Obstetrics and Gynecology, Osaka Red Cross Hospital, Osaka, Japan.
⁴ Department of Obstetrics and Gynecology, Kurashiki Central Hospital, Okayama, Japan.
⁵ Department of Obstetrics and Gynecology, Shizuoka General Hospital, Shizuoka, Japan.
⁶ Department of Obstetrics and Gynecology, Medical Research Institute Kitano Hospital, Osaka, Japan.
⁷ Department of Obstetrics and Gynecology, Faculty of Medicine, Kindai University, Osaka, Japan.
⁸ Department of Obstetrics and Gynecology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan.
⁹ Department of Obstetrics and Gynecology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
¹⁰ Department of Obstetrics and Gynecology, National Hospital Organization Osaka National Hospital, Osaka, Japan.
¹¹ Department of Obstetrics and Gynecology, Kobe City Medical Center General Hospital, Hyogo, Japan.
¹² Department of Obstetrics and Gynecology, Japanese Red Cross Otsu Hospital, Shiga, Japan.
¹³ Department of Obstetrics and Gynecology, Shiga General Hospital, Shiga, Japan.
¹⁴ Department of Obstetrics and Gynecology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan.

PMID: 39779654
DOI: 10.1007/s10147-024-02687-w

Abstract

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.

Keywords: Monocyte to lymphocyte ratio; Neutrophil to lymphocyte ratio; Platelet to lymphocyte ratio; Systematic inflammatory response; Uterine carcinosarcoma.

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Conflict of interest statement

Declarations. Conflict of interest: The authors have no relevant financial or non-financial interests to disclose. Ethical approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by the Bioethics Committee of Kyoto University (No. R3055).

References

1. Galaal K, Godfrey K, Naik R et al (2011) Adjuvant radiotherapy and/or chemotherapy after surgery for uterine carcinosarcoma. Cochrane Database Syst Rev 1:6812. https://doi.org/10.1002/14651858.CD006812.pub2 - DOI
1. Major FJ, Blessing JA, Silverberg SG et al (1993) Prognostic factors in early-stage uterine sarcoma. A Gynecologic Oncology Group study. Cancer 71(4 Suppl):1702–1709. https://doi.org/10.1002/cncr.2820710440 - DOI - PubMed
1. Cree IA, White VA, Indave BI et al (2020) Revising the WHO classification: female genital tract tumours. Histopathology 76(1):151–156. https://doi.org/10.1111/his.13977 - DOI - PubMed
1. Bansal N, Herzog TJ, Seshan VE et al (2008) Uterine carcinosarcomas and grade 3 endometrioid cancers: evidence for distinct tumor behavior. Obstet Gynecol 112(1):64–70. https://doi.org/10.1097/AOG.0b013e318176157c - DOI - PubMed
1. Giuntoli RL 2nd, Metzinger DS, DiMarco CS et al (2003) Retrospective review of 208 patients with leiomyosarcoma of the uterus: prognostic indicators, surgical management, and adjuvant therapy. Gynecol Oncol 89(3):460–469. https://doi.org/10.1016/s0090-8258(03)00137-9 - DOI - PubMed

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

Affiliations

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

Authors

Affiliations

Abstract

Conflict of interest statement

References

MeSH terms

LinkOut - more resources

Full Text Sources

Medical