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 andp= 0.0124); meanwhile, preoperative values of CA125, PLR and MLR were not associated with the overall survival values (p= 0.5612,p= 0.6137 andp= 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.
卵巢癌仍是全球范围内致死率最高的妇科恶性肿瘤之一，因此研究重点聚焦于寻找新的预后因素，以帮助临床医生甄别最适宜直接手术的患者与更适合先行新辅助系统治疗再行间歇性肿瘤细胞减灭术的病例。本研究旨在探讨术前炎症指标是否可作为晚期卵巢癌的预后预测因子。材料与方法：回顾性分析2014年至2020年间在坎塔库齐诺临床医院接受手术治疗的57例晚期卵巢癌患者资料。采用受试者工作特征曲线确定不同炎症标志物对总生存期分析的最佳截断值。分析参数包括术前CA125水平、单核细胞/淋巴细胞比值（MLR）、血小板/淋巴细胞比值（PLR）、中性粒细胞/淋巴细胞比值（NLR）及全身免疫炎症指数（SII）。结果：单因素分析显示，基线CA125 > 780 µ/mL、NLR ≥ 2.7、MLR > 0.25、PLR > 200及全身免疫炎症指数（SII，定义为血小板计数×中性粒细胞/淋巴细胞比值）≥ 84,1000与显著缩短的无病生存期和总生存期相关。多因素分析中，MLR与SII与总生存期显著相关（p<0.0001，p=0.0124）；而术前CA125、PLR及NLR水平与总生存期无显著相关性（p值分别为0.5612、0.6137、0.1982）。结论：术前MLR与SII水平升高的患者即使接受完全肿瘤细胞减灭术，预后仍可能较差，此类患者应考虑采用新辅助系统治疗联合间歇性手术的治疗策略。
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