Ricerc@Sapienza

Cervical cancer (CC) is the fourth most common malignancy of women worldwide, with 13,240 new cases and an estimated 4,170 deaths in 2018 in the United States, according to national cancer institute [www.cancer.gov]. Nearly one-third of CC patients die from disease recurrence or progression [Arbyn M 2011]. The treatment depends on the stage; surgical treatment of invasive CC includes radical surgery [Landoni 1997], in locally advanced stages (IB2-IVA) the exclusive concomitant radio-chemotherapy treatment, currently constitutes the therapeutic standard [Rose PG 2002]. The neoadjuvant chemotherapy treatment followed by radical surgery in the IB2-IVA stages constitutes a therapeutic option widely used in Italy [Zanaboni F 2013]. As reported by a North American retrospective study with 564 patients the greatest incidence of recurrence is at 18-24 months from diagnosis, with 30-45% of cases are locoregional [Webb MJ 1980]. The International Federation of Obstetricians and Gynecologists (FIGO) tumor staging system, lymph node status, tumor size, histological grade, and depth of invasion were well known to be the prognostic factors of patients with CC [Li C 2016]. Clinical staging has been shown to be frequently inaccurate in predicting the prognosis of CC patients, especially in some patients with advanced disease [Tangjitgamol S 2014]. Therefore, a pretreatment and effective parameter to evaluate survival and prognosis of CC is necessary for decision-making concerning clinical therapy. For this reason new possible markers of tumor progression or response to treatment have been analyzed in inflammation and immunity processes. In particular, neutrophils to lymphocytes ratio (NLR), platelet-to-lymphocyte ratio (PLR), have recently been correlated to prognosis in different cancers, including cervical cancer [Nakamura 2015]. The aim of our study is to determine the prognostic role of NLR in cervical cancer.