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March 7, 2026Journal of Clinical Medicine0 citationsOpen Access

The Pretreatment Glucose-to-Lymphocyte Ratio as an Independent Prognostic Biomarker in Ovarian Cancer

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EBEce BaydarYTYasemin Bakkal TemiİÇİlkay Çıtakkul

Key Points

  • This research aims to evaluate the significance of the glucose-lymphocyte ratio (GLR) as a prognostic marker in epithelial ovarian cancer.
  • Retrospective cohort study of 326 patients with epithelial ovarian cancer.
  • Computed GLR using pre-treatment fasting blood glucose and absolute lymphocyte counts.
  • Established optimal GLR cutoff via receiver operating characteristic (ROC) analysis.
  • Analyzed overall survival (OS) and disease-free survival (DFS) with Kaplan–Meier and Cox regression models.
  • Performed sensitivity analyses excluding patients with diabetes mellitus.
  • Optimal GLR cutoff value was determined at 3.42.
  • Patients with high GLR (>3.42) had a median OS of 58 months compared to 151 months for low GLR (≤3.42) (p < 0.001).
  • High GLR patients had a median DFS of 17 months, significantly shorter than 49 months for low GLR (p < 0.001).
  • Higher GLR correlated with a worse overall survival (HR: 1.561; p = 0.018).
  • High GLR group demonstrated a greater disease progression rate (55.1% vs. 29.5%, p < 0.001).

Abstract

Background/Objectives: This study aimed to assess the prognostic significance of the glucose-lymphocyte ratio (GLR) prior to therapy in individuals with epithelial ovarian cancer. Methods: This retrospective cohort study included 326 patients with epithelial ovarian cancer who were treated from 2011 to 2025. The GLR was computed utilizing pre-treatment fasting blood glucose levels and absolute lymphocyte numbers. The optimal GLR cutoff value was established by receiver operating characteristic (ROC) analysis. Overall survival (OS) and disease-free survival (DFS) were assessed utilizing Kaplan–Meier analysis and Cox regression models. Additional sensitivity analyses were performed excluding patients with diabetes mellitus and by testing the interaction between GLR and neoadjuvant chemotherapy. Results: The optimal GLR cutoff value was 3.42. Patients were classified into low-GLR (≤3.42; n = 190) and high-GLR (>3.42; n = 136) groups. Patients with high GLR levels (>3.42) had a median OS of 58 months, which was significantly shorter than the 151 months for patients with low GLR levels (≤3.42) (p < 0.001). They also had a median DFS of 17 months, which was significantly shorter than the 49 months for patients with low GLR levels (p < 0.001). Multivariable Cox regression analysis showed that a higher GLR is an independent prognostic factor related to shorter overall survival (HR: 1.561; 95% CI: 1.078–2.261; p = 0.018). Findings remained consistent after excluding patients with diabetes mellitus. The group with a high GLR had a greater rate of disease progression (55.1% vs. 29.5%, p < 0.001). Conclusions: The pre-treatment GLR may serve as a simple and readily available prognostic biomarker in epithelial ovarian cancer, potentially supporting basic risk stratification; however, external validation is required.

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Cite This Study

Baydar et al. (2026) studied this question.

synapsesocial.com/papers/69abc2355af8044f7a4eb8e9https://doi.org/10.3390/jcm15051999
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