title: Platelet to lymphocyte ratio as a prognostic factor for epithelial ovarian cancer.
abstract: OBJECTIVE
  To determine whether preoperative platelets to lymphocyte ratio (PLR) could predict disease stage, surgical outcome, and survival in patients with epithelial ovarian cancer (EOC).
  
  
  METHODS
  Medical records of EOC patients who had surgery between January 2004 and December 2010 were reviewed. Clinicopathological and complete blood count data were collected. The optimal predictive value of PLR to predict advanced stage, suboptimal surgery, and survival was determined and compared with those of thrombocytosis (≥400,000 cells/mm(3)) and neutrophil to lymphocyte ratio (NLR) ≥2.6.
  
  
  RESULTS
  A total of 166 EOC patients were included in the study. PLR of 200 yielded better predictive values than those of thrombocytosis and NLR ≥2.6. The area under curve (AUC), sensitivity, specificity, positive and negative predictive values, and accuracy of PLR to predict advanced stage were: 0.66, 59.0%, 72.7%, 65.7%, 66.7%, and 66.3%, respectively. The corresponding values to predict suboptimal surgery were: 0.70, 70.0%, 69.8%, 50.0%, 84.4%, and 69.9%. The patients who had PLR≥200 had significantly shorter progression-free and overall survivals than those with PLR<200. Stage, grade, surgical outcome, thrombocytosis, and PLR were significant prognostic factors for survivals by univariable analyses while only stage remained significant by multivariable analysis.
  
  
  CONCLUSIONS
  PLR had potential clinical value in predicting advanced stage disease or suboptimal surgery. PLR was a better prognostic indicator for survivals of EOC patients compared to thrombocytosis or NLR>2.6.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, University of Bangkok Metropolis, Bangkok, Thailand.
authors.forename: Supachai
authors.initials: S
authors.lastname: Raungkaewmanee
authors.forename: Siriwan
authors.initials: S
authors.lastname: Tangjitgamol
authors.forename: Sumonmal
authors.initials: S
authors.lastname: Manusirivithaya
authors.forename: Sunamchok
authors.initials: S
authors.lastname: Srijaipracharoen
authors.forename: Thaovalai
authors.initials: T
authors.lastname: Thavaramara
keywords: Epithelial ovarian cancer; Optimal surgery; Platelets to lymphocyte ratio; Stage; Survival