803P Pre-treatment Systemic Inflammatory Markers Predict Survival in Endometrial Cancer Cases: A Japanese Gynaecologic Oncology Group 2043 Exploratory Data Analysis

Japanese Gynecologic Oncology Group (JGOG) 2043 was a trial to assess the efficacy of three different chemotherapeutic regimens as adjuvant therapy in endometrial cancer (EC) patients with post-operative recurrent risk. Inflammation predisposes patients to tumorigenesis by damaging DNA, stimulating angiogenesis, and potentiating pro-proliferative and anti-apoptotic processes. This study investigated whether pre-treatment systemic inflammatory markers (PTSIMs) are associated with survival outcomes in EC. Women with EC were recruited to the JGOG 2043 study, excluding patients who did not receive chemotherapy and those lost to follow-up. PTSIMs, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and hemoglobin, albumin, lymphocyte, and platelet (HALP) score were analysed in terms of clinicopathological factors, progression-free survival (PFS), and overall survival (OS). Optimal cut-off values for NLR, PLR, and HALP score were determined using the web application Cutoff Finder for PFS and OS. Survival estimates were calculated using the Kaplan–Meier method. Differences in survival between groups were assessed using a log-rank test. In total, 712 patients were enrolled in the JGOG 2043 study, with a median age of 59 years (interquartile range (IQR), 52–64) and body mass index (BMI) of 22.4 kg/m2 (IQR 19–25). The optimal cut-off values for PFS were 1.478 for NLR, 0.01695 for PLR, and 35.52 for HALP score. Similarly, the optimal cut-off values for OS were 1.88 for NLR, 0.02623 for PLR, and 19.87 for HALP score. Regarding the optimal cut-off values for PFS, NLR was associated with BMI; PLR with age, BMI, and surgical stage; and HALP score with BMI, surgical stage, and lymph node metastasis. For the optimal cut-offs for OS, NLR was associated with BMI, PLR, and BMI; and HALP score was associated with age and BMI. In PFS, HALP score was the prognostic factor (NLR: p=0.068; PLR: p=0.086; HALP score: p=0.025). In OS, PLR and HALP score were prognostic factors (NLR: p=0.1; PLR: p=0.028; HALP score: p=0.028). PTSIMs are associated with survival outcomes in EC. In particular, HALP score was a prognostic factor for both PFS and OS.