Pre-Operative Neutrophil-to-Lymphocyte Ratio as a Predictor of Post-Operative Infectious Morbidity in Gynecologic...

Area of Science:

• Oncology
• Surgical Pathology
• Biomarkers

Background:

• Neutrophil-to-lymphocyte ratio (NLR) is a recognized predictor of survival and post-operative complications.
• Its utility in predicting infectious morbidity in gynecologic cancer surgery requires further investigation.

Purpose of the Study:

• To evaluate the effectiveness of pre-operative neutrophil-to-lymphocyte ratio (NLR) as a biomarker for predicting post-operative infectious morbidity in patients undergoing gynecologic cancer surgery.
• To assess NLR's role in predictive models for identifying at-risk patients.

Main Methods:

• Prospective cohort study including 208 patients with gynecologic cancer.
• Evaluation of post-operative infectious morbidity within a 30-day follow-up period.
• Statistical analyses including logistic regression, Cox regression, random forest, and decision trees.

Main Results:

• Post-operative infectious morbidity occurred in 20.5% of patients.
• An optimal pre-operative NLR cutoff of 1.7 demonstrated 76.7% sensitivity and 73.3% specificity (AUC 0.760).
• NLR was a significant predictor of morbidity (univariable logistic regression) and associated with the timing of infectious morbidity (HR 1.339).
• Predictive models using random forest and decision trees achieved over 90% diagnostic accuracy.

Conclusions:

• Pre-operative neutrophil-to-lymphocyte ratio (NLR) shows potential as a valuable biomarker for assessing the risk of post-operative infectious morbidity in gynecologic cancer patients.
• NLR can be incorporated into predictive models to improve risk stratification and patient management.