ESTRO 2024 - Abstract Book

S1055

Clinical - Gynaecology

ESTRO 2024

1203 Study. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 38(15), 1685– 1692. https://doi.org/10.1200/JCO.19.02381

2024

Digital Poster

Long-term Effects of Hematological Parameters on Prediction of Recurrence in Cervix Cancer Patients

Aysenur Elmali 1 , Ozan Cem Guler 2 , Cem Onal 2,1

1 Baskent University, Faculty of Medicine, Radiation Oncology, Ankara, Turkey. 2 Baskent University, Faculty of Medicine, Adana Dr Turgut Noyan Research and Treatment Center, Radiation Oncology, Adana, Turkey

Purpose/Objective:

Cervical cancer prognosis depends on various factors, including cancer stage, treatment type, and patient characteristics. Immunoinflammatory indices, including platelet-to-lymphocyte ratio (PLR), neutrophil-to lymphocyte ratio (NLR), and hemoglobin (Hgb) levels, exhibit potential as prognostic and/or predictive indicators for cervical cancer patients. This study investigated these indices' association with local recurrence (LR) and distant metastasis (DM) in cervical cancer patients treated with definitive chemoradiotherapy.

Material/Methods:

The clinicopathological and hematological parameters of 261 patients with cervical squamous cell carcinoma histology who had received definitive intent treatment involving external beam radiotherapy, concurrent chemotherapy, and brachytherapy with a minimum 5-year follow-up were evaluated in this retrospective study. Patients who had undergone radical hysterectomy, had a history of other cancers, had distant metastasis at the time of diagnosis, or had active infections or hematologic disorders that caused hematological parameters were excluded. ROC analysis was performed to establish the cut-off values for the NLR, PLR and Hgb. Local recurrence free survival (LRFS), distant metastasis-free Survival (DMFS), and overall survival (OS) were determined using the Kaplan-Meier method. Univariate and multivariate regression analyses were employed to identify predictive and prognostic factors for DM and LR.

Results:

The median age was 57 years (range: 19-89 years), and the median follow-up time was 10.9 years (IQR: 9.8-11.9 years). Progression occurred in 132 patients (50.6%) at a median time of 11.2 months (range: 1-107.5 months) after completion of treatment. Seventy patients (53%) progressed within the first year, and 100 patients (75.8%) progressed within the second year of treatment. Among the 132 patients who experienced recurrence, the patterns were observed as follows: 44 patients (33.3%) experienced LR, 48 patients (36.4%) had DM, and 20 patients (15.2%) experienced both LR and DM. We found no significant differences in Hgb levels concerning the absence or presence of LR (11.1±1.7 g/dL vs. 11.5±1.6 g/dL; p = 0.11) and DM (11.7±1.4 vs. 11.4±1.6; p = 0.12). However, we observed significantly higher NLR and PLR values in patients with both LR and DM compared to those without these conditions, indicating the potential of NLR and PLR as valuable indicators for predicting the occurrence of LR and DM. Age, stage, tumor size, lymph node metastasis, NLR, PLR, and Hgb were found to be significant predictors of LR and DM in univariate analyses, while lymph node metastasis, NLR, PLR, and Hgb were