Prognostic Values of Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in Patients with Gynecologic Carcinosarcomas MAGYCS Study from the French TMRG Network

Background: Gynecological carcinosarcomas (GC) are rare but aggressive tumors.After surgery, there is no consensus on the optimal adjuvant therapy and new prognostic factors may help in decision-making.The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are robust indicators of inflammation often observed in GC.Objective: To assess the prognostic value of NLR and PLR on overall survival (OS) and progression-free survival (PFS) at 2 years from diagnosis in women with GC.Methods: Patients followed up for ovarian or uterine GC diagnosed between January 2011 and December 2018 were included in this multicenter retrospective study conducted within the French TMGR network.NRL and PLR outcomes were collected at diagnosis.Survival analysis according to PLR and NLR respectively were performed with univariate and multivariable Cox models including identified prognostic factors.Results: 148 patients were included.At diagnosis, the median age was 69 years, 30% had an ovarian and 70% a uterine primary localization, 61% had a FIGO stage III/IV.The 2-year OS rate was 55.7% and 2-year PFS was 40.2%.A relevant cut-off of 4 for NLR and 277 for PLR were defined by ROC curves.In univariate analysis, OS and PFS were significantly worse in patients with NLR>4 (p=0.0027 and p=0.017), and in patients with PLR>277 (p=0.019 and p= 0.006).In the multivariable analysis, NLR>4, and PLR>277 remained independent prognostic factors for OS in addition to age, uterine primary, and stage III/ IV.Conclusion: PLR and NLR at diagnosis are important independent prognostic factors in the management of GCs.