|
1
|
Balescu I, Eftimie M, Petrea S, Diaconu C, Gaspar B, Pop L, Varlas V, Hasegan A, Martac C, Bolca C, Stoian M, Stroescu C, Zgura A, Bacalbasa N. Prognostic Significance of Preoperative Inflammation Markers on the Long-Term Outcomes in Peritoneal Carcinomatosis from Ovarian Cancer. Cancers (Basel) 2024; 16:254. [PMID: 38254745 PMCID: PMC10814080 DOI: 10.3390/cancers16020254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 12/26/2023] [Accepted: 12/31/2023] [Indexed: 01/24/2024] Open
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.
Collapse
Affiliation(s)
- Irina Balescu
- “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Mihai Eftimie
- Department of Surgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.E.); (S.P.); (B.G.); (N.B.)
- Department of Visceral Surgery, Center of Excellence in Translational Medicine “Fundeni” Clinical Institute, 022328 Bucharest, Romania;
| | - Sorin Petrea
- Department of Surgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.E.); (S.P.); (B.G.); (N.B.)
- Department of Surgery, “Ion Cantacuzino” Clinical Hospital, 010024 Bucharest, Romania
| | - Camelia Diaconu
- Department of Internal Medicine, “Floreasca” Clinical Emergency Hospital, 014461 Bucharest, Romania;
- Department of Internal Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Bogdan Gaspar
- Department of Surgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.E.); (S.P.); (B.G.); (N.B.)
- Department of Visceral Surgery, “Floreasca” Clinical Emergency Hospital, 014461 Bucharest, Romania
| | - Lucian Pop
- Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (L.P.); (V.V.)
- Department of Obstetrics and Gynecology, National Institute of Mother and Child Care, Alessandrescu-Rusescu, 127715 Bucharest, Romania
| | - Valentin Varlas
- Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (L.P.); (V.V.)
- Department of Obstetrics and Gynecology, “Filantropia” Clinical Hospital, 011171 Bucharest, Romania
| | - Adrian Hasegan
- Department of Urology, Sibiu Emergency Hospital, Faculty of Medicine, University of Sibiu, 550245 Sibiu, Romania;
| | - Cristina Martac
- Department of Anesthesiology, Fundeni Clinical Hospital, 022328 Bucharest, Romania;
| | - Ciprian Bolca
- Department of Thoracic Surgery, ‘Marius Nasta’ National Institute of Pneumology, 010024 Bucharest, Romania;
- Faculty of Medicine and Health Sciences, Sherbrooke University, Sherbrooke, QC J1K 2R1, Canada
- Department of Thoracic Surgery, ‘Charles LeMoyne’ Hospital, Longueuil, QC J4V 2H1, Canada
| | - Marilena Stoian
- Department of Internal Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Internal Medicine and Nephrology, Dr. Ion Cantacuzino Hospital, 010024 Bucharest, Romania
| | - Cezar Stroescu
- Department of Visceral Surgery, Center of Excellence in Translational Medicine “Fundeni” Clinical Institute, 022328 Bucharest, Romania;
| | - Anca Zgura
- Department of Medical Oncology, Oncological Institute Prof. Dr. Al. Trestioreanu, 022328 Bucharest, Romania;
- Department of Medical Oncology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Nicolae Bacalbasa
- Department of Surgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.E.); (S.P.); (B.G.); (N.B.)
- Department of Visceral Surgery, Center of Excellence in Translational Medicine “Fundeni” Clinical Institute, 022328 Bucharest, Romania;
| |
Collapse
|