Abstract

INTRODUCTION

Systemic inflammation and immune response are closely related to cancer prognosis. Systemic immune-inflammation index (SII), prognostic nutritional index (PNI) and C-reactive protein/albumin ratio (CAR) are known to be prognostic in various cancer. However, in epithelial ovarian cancer (EOC) cases, there is little information about inflammatory indexes. Therefore, we investigated the prognostic importance of inflammation-based indexes such as SII, PNI and CAR in EOC patients.

METHODS

Two hundred and seventy three patients with EOC were included in this study retrospectively. Relationship between clinical variables with progression-free survival (PFS) and overall survival (OS) were analyzed via Kaplan–Meier method. The best cut-off points were determined using a receiver operating characteristic (ROC) curve analysis. SII, PNI, and CAR were classified based on cutoff points 1559, 42.1 and 3.11, respectively. Prognostic importance of the variables for OS was determined with the Cox regression model.

RESULTS

Low SII (<1559), high PNI (≥42.1) and low CAR (<3.11), were found to be associated with longer PFS and OS times in patients with EOC. In univariate analysis, age, menopausal status, Eastern Cooperative Oncology Group (ECOG) score, epithelial subtype, stage, SII, PNI and CAR were significantly associated with OS. In multivariate analysis stage, SII and PNI were found to be independent prognostic factors for OS (p <0.001, p <0.024, p<0.006, respectively).

DISCUSSION AND CONCLUSION

Pre-treatment SII and PNI are prognostic biomarkers that can be used to predict OS in patients with EOC.