Prognostic relevance of pretreatment peripheral neutrophil count and neutrophil-to-lymphocyte ratio in primary cutaneous angiosarcoma

Systemic inflammatory response markers, including neutrophil-to-lymphocyte ratio, platelet-to-lympho-cyte 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 an-giosarcoma. 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 progres-sion-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, respectiv-ely) 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 angiosar-coma, as well as in other types of soft-tissue sarcoma.