Preoperative neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), and platelet to lymphocyte ratio (PLR) as prognostic markers in patients with retroperitoneal liposarcoma

Abstract

Retroperitoneal liposarcomas are rare mesenchymal tumors of that are typically detected in advanced stages and often carry a poor prognosis. The recurrence rate is high even after an adequate treatment. The multimodality therapy is not a standard for every case; therefore, an individual risk assessment is needed to select tailored treatment plans. Several inflammatory ratios have been proposed as prognostic factors and may aid in the treatment selection. Objective: To analyze the impact of preoperative inflammatory-related ratios as prognostic factors in patients with retroperitonea liposarcoma. Methods: We retrospectively evaluated 87 individuals diagnosed with retroperitoneal liposarcoma from a high-volume sarcoma center during January 1, 2008, to December 31, 2018. The relation between preoperative inflammatory indices (neutrophil/lymphocyte, lymphocyte/monocyte and platelet/lymphocyte ratios) and the disease-free survival (DFS) and overall survival (OS) were analyzed. Results: Fifty (57.5%) participants were men and thirty-seven (42.5%) were women. The mean age at diagnosis was 53.64 years (SD ± 13.18). The mean tumor size was 27.79 cm (SD ± 13.48). The most common histological subtype was dedifferentiated liposarcoma (ddLPS) in 49.4% (n = 43) cases, followed by well-differentiated liposarcomas (wdLPS) in 44.8% (n = 39) cases. An analysis of the ROC (receiver operating characteristic) curve. was applied, and only the NLR was useful and associated with a worse OS (p = 0.047), with a cut-off point of 2.77. Conclusion: In our series, the NLR > 2.77 was an independent prognostic factor associated with lower overall survival in our series. Due to its easy accessibility and reproducibility, we believe that it can be a useful test in the clinical practice and potentially be included in risk prediction nomograms.

Keywords

• Retroperitoneal liposarcoma
• Neutrophil-to-lymphocyte ratio
• Prognostic factor
• Systemic inflammatory responses