Preoperative multiplication of neutrophil and monocyte counts as a prognostic factor in epithelial ovarian cancer

BACKGROUND: Epithelial ovarian cancer (EOC) is leading cause of death in gynecologic cancer, and finding prognostic factors is important for establishing treatment plans. OBJECTIVE: The aim of this study was to investigate the prognostic value of the multiplication of neutrophil and monocyte counts (MNM) in epithelial ovarian cancer (EOC). METHODS: Data were retrospectively collected from Samsung Medical Center for EOC patients treated from January 2002 to December 2012. MNM was determined by multiplying neutrophil and monocyte counts and dividing by 10,000. Sensitivity and specificity of markers were assessed using receiver operating characteristic curves. RESULTS: We included 674 patients with EOC. For predicting overall survival (OS), the area under the curve for MNM was 0.607 (95% CI, 0.554-0.661) with sensitivity 55.2% and specificity 63.2% (cut-off value 197.40). The ability of MNM to determine OS was similar to that of the previously validated NLR and PLR. When the cohort was divided by cut-off values, poorer survival outcomes were observed in the group with higher MNM. HigherMNM was associated with advanced stage and presence of residual disease after primary treatment. CONCLUSIONS: Elevated pretreatment MNM is an independent predictor of poor survival and can be a useful biomarker in patients with EOC.