Prognostic value of systemic inflammatory markers in predicting neoadjuvant platinum response and platinum resistance in advanced epithelial ovarian cancer: A peritoneal cancer index-based analysis
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引用次数: 0
Abstract
Objective
This study aimed to evaluate the prognostic value of pre-treatment systemic inflammatory indices in predicting the response to platinum-based neoadjuvant chemotherapy in patients with advanced ovarian cancer (AOC), as measured by the reduction rate of the Peritoneal Cancer Index (PCI). Additionally, the study sought to assess the predictive power of these markers in identifying patients likely to develop platinum resistance.
Methods
Systemic inflammatory markers including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR) and systemic immune-inflammation index (SII) were recorded prior to treatment in patients diagnosed with FIGO stage IIIc-IV epithelial ovarian cancer who received neoadjuvant chemotherapy followed by interval debulking surgery. Correlations between these markers and post-treatment PCI reduction rates were analyzed. The predictive ability of these markers for platinum resistance was evaluated using receiver operating characteristic (ROC) curve analysis.
Results
Pre-treatment systemic inflammatory markers showed a statistically significant positive correlation with PCI reduction rate. Higher baseline values, particularly of SII, were associated with a greater PCI reduction, indicating a stronger response to chemotherapy. SII demonstrated the highest diagnostic accuracy for predicting platinum resistance, with an area under the curve (AUC) of 0.790. Optimal cut-off values for NLR (>11.43) and SII (>2223.15) were identified, showing good sensitivity and specificity for predicting resistance.
Conclusion
Systemic inflammatory indices, especially SII, appear to be valuable predictive and prognostic biomarkers in AOC. Their use in pre-treatment evaluation may help identify patients at risk of poor chemotherapy response and guide personalized treatment strategies, including the potential need for combination therapies such as bevacizumab.
期刊介绍:
Gynecologic Oncology, an international journal, is devoted to the publication of clinical and investigative articles that concern tumors of the female reproductive tract. Investigations relating to the etiology, diagnosis, and treatment of female cancers, as well as research from any of the disciplines related to this field of interest, are published.
Research Areas Include:
• Cell and molecular biology
• Chemotherapy
• Cytology
• Endocrinology
• Epidemiology
• Genetics
• Gynecologic surgery
• Immunology
• Pathology
• Radiotherapy