Systemic inflammatory response in gynecologic cancers

Abstract

The role of inflammatory response in carcinogenesis is the subject of numerous studies. A concept of systemic inflammatory response was developed to identify the relationship between increased inflammatory response and the course of cancer and prognosis. Inflammatory markers are used to estimate progression-free survival in e.g. colon cancer. Some inflammatory markers are also useful in estimating total survival in patients with esophageal, liver, gastric or pancreatic cancer. In this paper, we evaluated the current state of knowledge on the role of inflammatory markers in estimating prognosis in patients with endometrial, ovarian and cervical cancer. The markers used include the neutrophil-to-lymphocyte ratio (NLR), Glasgow Prognostic Score (GPS), Modified GPS (mGPS), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR). There are ongoing studies investigating the role of neutrophils in increasing the production of vascular endothelial growth factor (VEGF) - one of the key mediators of neoangiogenesis in tumors. Well-known inflammatory markers, such as C-reactive protein (CRP), elevated levels of which may indicate shorter survival in ovarian carcinoma, are also useful. There is preliminary evidence supporting the relationship between increased inflammatory response and prognosis in gynecologic cancers. However, prospective studies in larger patient populations are needed to introduce inflammatory markers into everyday clinical practice.