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Published online: 2024-06-06

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Prognostic significance of pretreatment clinical and laboratory features in patients with ovarian cancer receiving neoadjuvant chemotherapy

Serhat Sekmek1, Dogan Bayram1, Safa Can Efil1, Gokhan Ucar1, Mehmet Ali Nahit Sendur1, Fahriye Tugba Kos1


Introduction. In this study, we aimed to investigate the effects of pre-treatment clinical and laboratory characteristics on prognosis in ovarian cancer patients diagnosed in our clinic. In all patients, surgery was not possible, and they were qualified for neoadjuvant treatment. 

Material and methods. Records of 96 patients diagnosed with ovarian carcinoma, who were not eligible for the surgery at the time of diagnosis and who were qualified for neoadjuvant treatment, were reviewed retrospectively. 

Results. For the prognosis of OS, we analyzed age (p = 0.106), ECOG (p = 0.007), menstrual status (p = 0.211), FIGO stage (p = 0.314), ovarian origin of cancer (p = 0.571), albumin (p = 0.496), LDH (p = 0.940), CA- 125 (p = 0.032), neutrophil-lymphocyte ratio (NLR) (p = 0.194), platelet-lymphocyte ratio (PLR) (p = 0.002), systemic immune-inflammation index (SII) (p = 0.028), prognostic nutritional index (PNI) (p = 0.042), Charlson Comorbidity Index (ACCI) (p = 0.008), Cumulative Illness Rating Scale (CIRS) (p = 0.769), chemotherapy response score (CRS) (p = 0.235), cytoreduction (p = 0.006), the number of cycles of neoadjuvant chemotherapy (NACT) (p = 0.749), and the total number of cycles of both neoadjuvant and adjuvant treatment (p = 0.014). For the prognosis of DFS, we analyzed age (p = 0.697), ECOG (p = 0.088), menstrual status (p = 0.912), FIGO stage (p = 0.728), ovarian origin of cancer (p = 0.463), albumin (0.688), LDH (p = 0.028), CA-125 (p = 0.160), NLR (p = 0.417), PLR (p = 0.442), SII (p = 0.069), PNI (p = 0.779), ACCI (p = 0.487), CIRS (p = 0.858), CRS (p = 0.235) cytoreduction (p < 0.001), the number of cycles of NACT (p = 0.849), and the total number of cycles of both neoadjuvant and adjuvant treatment (p = 0.188). 

Conclusions. ECOG status, pre-treatment CA-125 level, pre-treatment immune-based markers PLR, SII, and PNI, among comorbidity scores: the ACCI score, total number of cycles of neoadjuvant and adjuvant treatment, and cytoreduction type were found to be factors affecting OS. Serum LDH level and cytoreduction type were the factors affecting DFS.

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