Neutrophil‐to‐lymphocyte ratio as a prognostic marker for survival outcomes in women with cervical cancer and HIV infection

OBJECTIVE: This study aimed to determine the prognostic value of neutrophil-to-lymphocyte ratio (NLR) in women with cervical cancer infected with HIV. METHODS: This retrospective cohort study included women with cervical cancer with HIV infection who underwent primary treatment at a tertiary hospital in southern Thailand between 2005 and 2019. Overall survival (OS) and progression-free survival (PFS) were analyzed using the Kaplan-Meier method. Univariate and multivariate Cox regression analyses were used to determine the independent factors associated with OS and PFS. RESULTS: Among 100 patients (median follow-up time 37.63 months), the 5-year OS and PFS rates were 64.5% (95% confidence interval [CI]: 55.0-75.6) and 58.2% (95% CI: 48.6-69.6), respectively. In the multivariate analysis, high NLR (hazard ratio [HR]: 3.53, 95% CI: 1.58-7.91, P = 0.002) and low equivalent total dose in 2 Gy fractions at point A (HR 2.14, 95% CI: 1.02-4.49, P = 0.045) were independent predictors of worse OS, while poor performance status (HR 6.73, 95% CI: 1.93-23.56, P = 0.003), adenocarcinoma histology (HR 3.32, 95% CI: 1.43-7.72, P = 0.005), and high NLR (HR 4.04, 95% CI: 1.87-8.73, P < 0.001) were independent predictors of worse PFS. CONCLUSION: High NLR independently predicts poor OS and PFS in women with cervical cancer with HIV.