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

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 $\ge$22, $\ge$1.98, $\ge$115.3, and $\le$4.71, respectively. The log-rank test revealed that the patients with a Ki-67 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 low-risk EC.

Endometrial cancer; Low-risk; Ki-67; NLR; Survival

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