Effects of neutrophil-to-lymphocyte ratio, tumor-infiltrating lymphocyte and neutrophil scores on prognosis in low-risk endometrial cancer

Background: This study aimed to determine the association of neutrophil-tolymphocyte ratio (NLR), tumor-infiltrating lymphocyte (TIL) and tumor-infiltrating neutrophil (TIN) scores with recurrence-free survival (RFS) in patients with low-risk endometrial cancer. Methods: A total of 233 low-risk endometrial cancer patients were retrospectively screened. The NLR values calculated from the peripheral blood and TIL and TIN scores from tumor tissues were compared for survival analyses. Results: There was no statistically significant difference in RFS according to the NLR with an optimal prognostic cut-off value of 2.4. The expected RFS time was 77.9 months (+/- 0.7, 95% Confidence Interval (CI): 76.5-79.3) for patients with an NLR <2.4 and 76.5 months (+/- 1.3, 95% CI: 73.7-79.2) for patients with an NLR >= 2.4 (p = 0.303). The expected RFS times were 69.9 months (+/- 2.7, 95% CI: 64.6-75.3) for patients with a TIL score of 1, 65.5 months (+/- 1.9, 95% CI: 61.3-69.4) for patients with a TIL score of 2, and 74.5 months for patients with a TIL score of 3 (+/- 1.9, 95% CI: 70.8-78.2), respectively. (score 1 vs. score 2, p = 0.031) (score 1 vs. score 3, p = 0.302) (score 2 vs. score 3, p = 0.018). Patients with a TIN score of 1 had a worse RFS than those with a TIN score of 0; 55.9 months (+/- 5.3, 95% CI: 45.4-66.4), versus 78.6 months (+/- 0.3, 95% CI: 77.9-79.3) (p < 0.001). Conclusions: A TIN score of 1 and a TIL score of 2 were associated with worse RFS in patients with low-risk endometrial cancer. No significant association was found with the NLR.