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J Cancer 2016; 7(5):538-545. doi:10.7150/jca.14206 This issue Cite

Research Paper

The Lymphocyte-Monocyte Ratio Predicts Patient Survival and Aggressiveness of Endometrial Cancer

Wan Kyu Eo¹, Sanghoon Kwon², Suk Bong Koh³, Min Jeong Kim⁴, Yong Il Ji⁵, Ji Young Lee⁶, Dong Soo Suh⁷, Ki Hyung Kim^{7* ✉}, Heung Yeol Kim^{8* ✉}

1. Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
2. Department of Obstetrics and Gynecology, Keimyung University, School of Medicine, Daegu, Korea
3. Department of Obstetrics and Gynecology, Catholic University of Daegu, School of Medicine, Daegu, Korea
4. Department of Obstetrics and Gynecology, The Catholic University of Korea, Seoul, Korea
5. Department of Obstetrics and Gynecology, College of Medicine, Inje University, Busan, Korea
6. Department of Obstetrics and Gynecology, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
7. Department of Obstetrics and Gynecology, Pusan National University School of Medicine; Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
8. Department of Obstetrics and Gynecology, College of Medicine, Kosin University, Busan, Korea
* Ki Hyung Kim and Heung Yeol Kim equally contributed to this work.

✉ Corresponding authors: Ki Hyung Kim, M.D., Ph.D., Department of Obstetrics and Gynecology, Pusan National University School of Medicine; Biomedical Research Institute, Pusan National University Hospital, Busan 602-739, Korea; Phone: +82-51-990-6226; Fax: +82-51-990-3300; e-mail: kihyungkimpnucom. Heung Yeol Kim, M.D., Ph.D., Department of Obstetrics and Gynecology, Kosin University College of Medicine, 34, Amnam-dong, Seo-gu, Busan 602-702, Korea; Phone: +82-51-990-6211; Fax: +82-51-241-5458; E-mail: hykyalecom More

Abstract

Objective: We assessed the prognostic implications of preoperative lymphocyte-monocyte ratio (LMR) in patients with endometrial cancer (EC).

Methods: We retrospectively examined the LMR as a prognostic variable in a cohort of 255 patients with EC who underwent surgical resection. Patients were categorized into two groups according to the LMR (LMR-low and LMR-high) using cutoff points determined by receiving operator characteristic (ROC) curve analysis. The primary objective was to correlate the LMR to clinicopathological factors; the secondary objective was to determine the survival significance of the LMR in patients with EC.

Results: Using data from the entire cohort, the most discriminative LMR cutoff value selected on the ROC curve was 3.28 for both disease-free survival (DFS) and overall survival (OS). The LMR-low and LMR-high groups included 33 (12.9%) and 222 patients (87.1%), respectively. The 5-year DFS rates in the LMR-low and LMR-high groups were 64.5 and 93.9% (P < 0.0001), respectively, and the 5-year OS rates in the two groups were 76.7 and 96.5% (P < 0.0001), respectively. On multivariate analysis, we identified histologic grade, International Federation of Gynecology and Obstetrics (FIGO) stage, and LMR levels as the strongest prognostic factors affecting DFS (P = 0.0037, P < 0.0001, and P < 0.0001, respectively), and FIGO stage and the LMR as the strongest prognostic factors predicting OS (P < 0.0001 and P < 0.0001, respectively).

Conclusion: The LMR is an independent prognostic factor for both DFS and OS after surgical resection, and it provides additional prognostic value beyond standard clinicopathological parameters.

Keywords: Monocytes, Lymphocytes, Endometrial Cancer

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