PDF(Pubmed)
Abstract：
Ovarian cancer remains one of the most lethal gynaecological malignancies affecting women worldwide; therefore, attention has been focused on identifying new prognostic factors which might help the clinician to select cases who could benefit most from surgery versus cases in which neoadjuvant systemic therapy followed by interval debulking surgery should be performed. The aim of the current paper is to identify whether preoperative inflammation could serve as a prognostic factor for advanced-stage ovarian cancer. Material and methods: The data of 57 patients who underwent to surgery for advanced-stage ovarian cancer between 2014 and 2020 at the Cantacuzino Clinical Hospital were retrospectively reviewed. The receiver operating characteristic curve was used to determine the optimal cut-off value of different inflammatory markers for the overall survival analysis. The analysed parameters were the preoperative level of CA125, monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR) and systemic inflammation index (SII). Results: Baseline CA125 > 780 µ/mL, NLR ≥ 2.7, MLR > 0.25, PLR > 200 and a systemic immune inflammation index (SII, defined as platelet × neutrophil-lymphocyte ratio) ≥ 84,1000 were associated with significantly worse disease-free and overall survival in a univariate analysis. In a multivariate analysis, MLR and SII were significantly associated with higher values of overall survival (p < 0.0001 and p = 0.0124); meanwhile, preoperative values of CA125, PLR and MLR were not associated with the overall survival values (p = 0.5612, p = 0.6137 and p = 0.1982, respectively). In conclusion, patients presenting higher levels of MLR and SII preoperatively are expected to have a poorer outcome even if complete debulking surgery is performed and should be instead considered candidates for neoadjuvant systemic therapy followed by interval surgery.
摘要：
卵巢癌仍然是影响全世界妇女的最致命的妇科恶性肿瘤之一；因此，人们将注意力集中在确定新的预后因素上,这些因素可能有助于临床医生选择最受益于手术的病例,而不是应该进行新辅助系统治疗后进行间隔减积手术的病例.本论文的目的是确定术前炎症是否可以作为晚期卵巢癌的预后因素。材料和方法：回顾性分析了2014年至2020年间在Cantacuzino临床医院接受晚期卵巢癌手术的57例患者的数据。受试者工作特征曲线用于确定不同炎症标志物的最佳截断值，以进行总体生存分析。分析的参数包括术前CA125水平，单核细胞与淋巴细胞比率（MLR），血小板与淋巴细胞比率（PLR），中性粒细胞与淋巴细胞比率（NLR）和全身炎症指数（SII）。结果：基线CA125>780µ/mL，NLR≥2.7，MLR>0.25，PLR>200和全身免疫炎症指数（SII，在单变量分析中,定义为血小板×中性粒细胞-淋巴细胞比率)≥84,1000与无病生存期和总生存期显著恶化相关.在多变量分析中，MLR和SII与更高的总生存率显著相关(p<0.0001和p=0.0124);同时,术前CA125,PLR和MLR值与总生存值无关(分别为p=0.5612,p=0.6137和p=0.1982).总之,术前MLR和SII水平较高的患者,即使进行了完全减积手术,其预后也会较差,因此应考虑接受新辅助系统治疗,然后进行间期手术.
