Pretreatment anemia status and elevated PLR affect the prognosis of locally advanced cervical squamous cell carcinoma patients treated with concurrent chemoradiotherapy

Abstract

Objective: To assess the prognostic value of platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and systemic immune-inflammation index (SII) in locally advanced cervical squamous cell carcinoma (LACSC) treated with concurrent chemoradiotherapy (CCRT) regimens. Methods: The contribution of systemic immune inflammatory response markers (NLR, PLR, LMR, SII), inflammatory cells (lymphocytes, neutrophils, monocytes, platelets), and hematocrit in predicting the outcomes of concurrent chemoradiotherapy treatment in LACSC patients was examined using the Kaplan-Meier univariate survival analysis method. Variables that were significant for the univariate analysis were included in the multivariate regression analysis to confirm the independent prognostic factors affecting concurrent chemoradiotherapy in LACSC patients. Results: Univariate analysis showed that age (p = 0.024), PLR (p = 0.007), NLR (p = 0.089), LMR (p = 0.021), SII (p = 0.087), and Hb (p = 0.004) were all prognostic factors affecting OS (over survival). Multivariate regression analysis revealed that PLR (p = 0.066) and Hb (p = 0.045) before concurrent chemoradiotherapy were independent risk factors of OS in the studied population. Moreover, these two factors were significantly correlated (correlation coefficient Rs = –0.426, p = 0.000). Conclusions: The results suggested that elevated PLR and anaemia are likely to have poorer prognoses in LACSC patients who initially received radical CCRT. Moreover, pre-treatment anemia status may exacerbate the prognostic effects of PLR.