International Journal of Hematology and Oncology 2022, Vol 32, Num 4 Page(s): 222-230
Clinical Significance of the Immune Prognostic Index in Patients with Endometrial Carcinoma

Bisar ERGUN1, Ilkay Tugba UNEK2, Huseyin Salih SEMIZ2, Bahadır SAATLI3, Zumre Arican ALICIKUS4, Funda Barlik OBUZ5, Meral KOYUNCUOGLU6, Aziz KARAOGLU2

1Dokuz Eylül University, Faculty of Medicine, Department of Internal Medicine and Critical Care, TURKIYE
2Dokuz Eylul University Faculty of Medicine, Department of Medical Oncology, TURKIYE
3Dokuz Eylul University, Faculty of Medicine, Department of Obstetrics and Gynecology, TURKIYE
4Dokuz Eylul University, Faculty of Medicine, Department of Radiation Oncology, TURKIYE
5Dokuz Eylül University, Faculty of Medicine, Department of Radiology, TURKIYE
6Dokuz Eylül University, Faculty of Medicine, Department of Pathology, Izmir, TURKIYE

Keywords: Endometrial cancer, Immune prognostic index, Lymphatic metastasis, Prognostic value
The immune prognostic index (IPI) is a new score that combines pretreatment serum lactate dehydrogenase (LDH) levels with a derived neutrophils/(leukocytes minus neutrophils) ratio (dNLR). Our objective was to determine the prognostic value of the IPI in endometrial cancer. This study included 94 patients diagnosed with endometrial cancer after surgical resection between 2000 and 2016. Clinicopathological data including preoperative laboratory results were analyzed retrospectively. The patients were divided into two groups according to the IPI score (good IPI, factor 0; poor IPI, factor 1-2). Of the 94 patients, 70 (74.5%) patients had stage III- IIIA-IIIB, and 24 (25.5%) patients had stage IIIC cancer; 68 (72.3%) had endometrioid histologic type. The good IPI group included 38 (40.4%) and the poor IPI group included 56 (59.6%) patients. The median DFS was 105.50 (95% CI: 79.89-131.11) months in the good IPI group and 82.61 (95% CI: 67.16-98.06) months in the poor IPI group (p= 0.791). The median OS was 120.05 (95% CI: 97.28-142.81) months in the good IPI group and 92.53 (95% CI: 79.10-105.96) months in the poor IPI group (p= 0.671). In the poor IPI group, the rate of stage IIIC patients was higher than those in the good IPI group (33.9% and 13.2%, respectively; p= 0.030). In multivariate analysis, a poor IPI score was independently associated with lymph node metastasis (OR: 3.59, 95%CI: 1.06-12.14, p= 0.040). In the endometrial cancer population, a poor IPI score may play a remarkable role in guiding optimal treatment strategies.