The Ki-67 index and neutrophile-lymphocyte ratio are prognostic factors in patients with low-risk endometrial cancer


ÇUBUKÇU E., ŞAHİN A. B. , ÖZ ATALAY F., OCAK B., ÖZŞEN M., DEMİRÖZ ABAKAY C., ...More

EUROPEAN JOURNAL OF GYNAECOLOGICAL ONCOLOGY, vol.42, no.4, pp.775-781, 2021 (Peer-Reviewed Journal) identifier identifier

  • Publication Type: Article / Article
  • Volume: 42 Issue: 4
  • Publication Date: 2021
  • Doi Number: 10.31083/j.ejgo4204117
  • Journal Name: EUROPEAN JOURNAL OF GYNAECOLOGICAL ONCOLOGY
  • Journal Indexes: Science Citation Index Expanded, Scopus, BIOSIS, EMBASE
  • Page Numbers: pp.775-781
  • Keywords: Endometrial cancer, Low-risk, Ki-67, NLR, Survival, CELL PROLIFERATION, EXPRESSION, IMPACT, ROLES, KI67, P53, PR, ER

Abstract

Objective: To investigate the prognostic factors comparing clinical, histopathological, and laboratory parameters in low-risk endometrial cancer (EC). Methods: In the present single-center study, multivariate Cox regression analysis was performed on retrospective clinical and laboratory data and histopathological features obtained from the re-evaluation of 253 patients with low-risk EC. Receiver operating characteristic curves (ROC) were plotted for neutrophile-lymphocyte ratio (NLR), platelet-lymphocyte ratio, lymphocyte-monocyte ratio and Ki-67 index for recurrence. Kaplan-Meier analysis was employed for survival rates. Results: The median age was 58.5 years (32.0-75.4). Most of the patients were obese and post-menopausal. In nearly half of the patients, lymphadenectomy was performed in addition to hysterectomy and oophorectomy. The median tumor size was 30 mm (range 2-80), and the median Ki-67 index was 25 (1-90). According to the ROC curve analysis, the cut-off values for the Ki-67 index, NLR, PLR, and LMR were determined as >= 22, >= 1.98, >= 115.3, and >= 4.71, respectively. The log-rank test revealed that the patients with a Ki67 index lower than 22% and NLR lower than 1.98 had statistically longer recurrence-free survival (RFS) (p = 0.002 for Ki-67 index and p = 0.004 for NLR). The multivariate analysis revealed that the Ki-67 index and NLR were statistically significant factors for RFS (p = 0.012 and p = 0.029, respectively). Conclusion: The present study highlights the prognostic implications of both the Ki-67 index and NLR in lowrisk EC.