Naples prognostic score is an independent prognostic factor in patients with operable endometrial cancer: Results from a retrospective cohort study

Abstract

Objective

Naples prognosis score (NPS) is a new immune and nutritional assessment method that can be used to predict tumor prognosis. This study aimed to identify whether NPS is an independent prognostic indicator of operable endometrial cancer (EC).

Materials and methods

We retrospectively analyzed 1038 patients with endometrial cancer who underwent surgery. Patients were grouped according to NPS (NPS group 0, n = 362; NPS group 1, n = 589; and NPS group 2, n = 87), and differences in clinical characteristics were compared among the groups. Survival analysis was performed by the Kaplan–Meier method, P values were calculated by log–rank test, and prognostic factors were assessed by Cox proportional hazards regression models.

Results

Serum albumin levels, total cholesterol levels, neutrophil–lymphocyte ratio, lymphocyte–monocyte ratio, total lymphocyte count, CA-125 levels, age, body mass index, FIGO stage, myometrial invasion depth, controlling nutritional status score, and systemic inflammation score were significantly different among the groups; significant differences in progression-free survival(PFS) and overall survival (OS) were also found. On multivariate analysis, NPS was identified as an independent prognostic factor for PFS (NPS group 0 vs. 1: aHR = 4.32, 95%CI = 1.133–16.47; NPS group 0 vs. 2: aHR = 21.336, 95%CI = 3.498–130.121) and OS (NPS group 0 vs. 1: aHR = 5.029, 95%CI = 1.638–15.441; NPS group 0 vs. 2: aHR = 20.789, 95%CI = 4.381–98.664). Moreover, NPS is an independent prognostic factor for PFS and OS in grade 2 or 3 EC (aHR = 7.768, 95%CI = 2.411–25.029 and aHR = 4.717, 95%CI = 1.794–12.407, respectively).

Conclusion

High NPS is associated with poor PFS and OS and is a valuable independent prognostic factor in patients with EC.