Pretreatment lymphocyte count as independent prognostic factor in patients with locally advanced cervical cancer treated with concurrent chemoradiotherapy

To evaluate the association between pretreatment total lymphocyte counts (TLC) and survival outcome in locally advanced cervical cancer (LACC) patients treated with definite concurrent chemoradiotherapy (CCRT).

We retrospectively reviewed the data of 789 patients diagnosed with cervical cancer stage IIB to IVA treated with CCRT between January 2011 and December 2015. We assessed the association of pretreatment TLC with 5-year disease-free survival (DFS) and overall survival (OS) rates.

Fifty-two patients had pretreatment TLC < 1000 cells/mm³ . The median pretreatment TLC in TLC groups <1000 cell/mm³ and ≥1000 cell/mm³ were 573.9 cells/mm³ (range, 350.9-827.7 cells/mm³ ) and 2211.3 cells/mm³ (range, 1751.3-2785.8 cells/mm³ ), respectively. Patients in pretreatment TLC < 1000 cell/mm³ group had a lower number of treatment responses. The 5-year DFS and OS rates were significantly higher in patients with pretreatment TLC ≥ 1000 cells/mm³ than their counterparts (67.7% vs. 35.4% [P < 0.0001] and 57.6% vs. 25.7% [P < 0.0001], respectively). In multivariate analysis, pretreatment TLC ≥ 1000 cells/mm³ was an independent predictor of DFS (HR, 0.39; 95% confidence interval [CI] 0.26-0.59, P < 0.001) and OS (HR, 0.59; 95% CI 0.42-0.84, P = 0.006).

Pretreatment TLC was associated with treatment response and survival outcome in patients with LACC treated with definite CCRT.