Kentaro Awaji, Takuya Miyagawa, Jun Omatsu, Hiroko Numajiri, Toru Kawai, Kaoru Funamizu, Ryosuke Saigusa, Daisuke Yamada, Yoshihide Asano, Shinichi Sato
DOI: 10.2340/00015555-3898

Systemic inflammatory response markers, including neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and monocyte-to-lymphocyte ratio, are useful prognostic factors for various malignant tumours. The aim of this study was to investigate the clinical relevance of these markers in primary cutaneous angiosarcoma. Twenty-six patients were retrospectively divided into 2 groups according to pretreatment peri­pheral blood cell counts or systemic inflammatory response marker levels; overall survival and progression-free survival were compared. Univariate analysis found that high neutrophil count (> 3.1×109/l), high neutrophil-to-lymphocyte ratio (> 2.4), high platelet-to-lymphocyte ratio (> 175) and low lymphocyte count (≤ 1.3×109/l) were related to shorter overall survival, while high neutrophil and low lymphocyte groups had shorter progression-free survival. In multivariate analysis, high neutrophil count and high neutrophil-to- lymphocyte ratio (hazard ratio 7.44 and 5.04, 95% confidence interval 1.48–37.2 and 1.26–20.1, respectiv­ely) were identified as independent prognostic factors for poor overall survival. These results indicate that systemic inflammatory response markers serve as prognostic predictors in primary cutaneous angiosarcoma, as well as in other types of soft-tissue sarcoma.

Peripheral neutrophil, lymphocyte and platelet counts and their ratios are readily available, and are reported to be useful to predict the prognosis of patients with various malignant tumours. In patients with primary cutaneous angiosarcoma, pretreatment high neutrophil count and high neutrophil-to-lymphocyte ratio are independently associated with shorter lifespan. Since the prognosis of cutaneous angiosarcoma is very poor, and aggressive treatments of patients with low life expectancy can sometimes reduce their quality of life, prognostic prediction may help us choose the best therapeutic options for patients with primary cutaneous angiosarcoma.