Impact of Pretreatment Blood Parameters on Survival Outcomes in Patients with Locally Advanced Cervical Cancer Treated with Concurrent Chemoradiotherapy: A Retrospective Cohort Study

Abstract

Objectives: To evaluate the association between systemic inflammatory markers and the albumin–globulin ratio (AGR) with prognostic outcomes in patients with locally advanced cervical cancer (LACC) treated with concurrent chemoradiation therapy (CCRT).

Materials and Methods: A retrospective cohort study was conducted at the Gynecologic Oncology Unit, Bhumibol Adulyadej Hospital, Royal Thai Air Force, Thailand. Medical records of patients with LACC treated between 2015 and 2019 were reviewed. Patients who completed definitive CCRT were included. Demographic characteristics, histopathological findings, FIGO stage, and pretreatment hematologic parameters were collected. Associations between inflammatory markers and survival outcomes were analyzed.

Results: A total of 110 patients were included, with a mean age of 49.8 years. Squamous cell carcinoma was the predominant histological subtype, accounting for 80.9% (89/110) of cases. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 61.8% and 57.8%, respectively. Patients with a neutrophilto- lymphocyte ratio (NLR) <2.33 had significantly better PFS, while those with an NLR <3.2 demonstrated significantly better OS than patients with higher NLR values. A platelet-to-lymphocyte ratio (PLR) <154 and an AGR >1.2 were also significantly associated with improved survival outcomes. Specifically, a higher AGR was associated with better PFS.

Conclusion: Pretreatment systemic inflammatory markers may provide useful prognostic information in patients with LACC undergoing definitive CCRT. Lower NLR and PLR values, together with a higher AGR, were associated with more favorable survival outcomes, supporting their potential role as inexpensive and readily available prognostic biomarkers.