Zhang Ying, Xing Wen, Liang Xiaoyi, Yang Zhujuan, Ma Yun, Chen Ying, Zhu Weipei
Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Front Oncol. 2025 Mar 11;15:1531987. doi: 10.3389/fonc.2025.1531987. eCollection 2025.
Elevated inflammatory markers are commonly linked to poor prognoses in cancer patients, while optimal nutritional status correlates with improved survival outcomes. This study aimed to explore the interplay between nutritional and inflammatory markers and their impact on postoperative outcomes in ovarian cancer patients through a retrospective analysis.
Data were retrospectively retrieved from patients diagnosed with ovarian cancer who required surgical intervention at the Department of Obstetrics and Gynecology. Overall survival (OS) and cancer-specific survival (CSS) were monitored during follow-up. Kaplan-Meier survival curves were employed to assess OS and CSS across different patient cohorts, evaluating the prognostic significance of nutritional and inflammatory markers. Nomograms for predicting OS and CSS at one, three, and five years postoperatively were constructed, followed by external validation.
The prognostic nutritional index (PNI) and Naples prognostic score (NPS) exhibited a significant correlation with OS and CSS in postoperative ovarian cancer patients ( 0.05). Analysis indicated that patients with a PNI > 51.2 demonstrated the most favorable survival outcomes. Furthermore, those with a low-NPS (L-NPS) had notably better survival rates compared to their high-NPS (H-NPS) counterparts. Independent OS predictors included age, PNI, NPS, histological type, tumor size, targeted therapy, and diabetes. Similarly, the CSS prediction model incorporated age, NPS, tumor size, targeted therapy, and diabetes. The nomograms demonstrated robust predictive accuracy for three- and five-year survival, though one-year calibration curves showed limited agreement. Despite slightly reduced external validation performance compared to the initial sample, the model maintained strong predictive capability.
The nutritional inflammatory index serves as a key independent prognostic marker for OS and CSS in ovarian cancer patients. Nomograms based on PNI and NPS provide valuable prognostic insights for postoperative management. Incorporating these indices into clinical practice could improve patient stratification and guide personalized treatment plans.
炎症标志物升高通常与癌症患者的不良预后相关,而最佳营养状态与改善生存结果相关。本研究旨在通过回顾性分析探讨营养和炎症标志物之间的相互作用及其对卵巢癌患者术后结局的影响。
回顾性收集在妇产科接受手术干预的卵巢癌患者的数据。在随访期间监测总生存期(OS)和癌症特异性生存期(CSS)。采用Kaplan-Meier生存曲线评估不同患者队列的OS和CSS,评估营养和炎症标志物的预后意义。构建术后1年、3年和5年预测OS和CSS的列线图,随后进行外部验证。
预后营养指数(PNI)和那不勒斯预后评分(NPS)与卵巢癌术后患者的OS和CSS显著相关(P<0.05)。分析表明,PNI>51.2的患者生存结局最佳。此外,低NPS(L-NPS)患者的生存率明显高于高NPS(H-NPS)患者。独立的OS预测因素包括年龄、PNI、NPS、组织学类型、肿瘤大小、靶向治疗和糖尿病。同样,CSS预测模型纳入了年龄、NPS、肿瘤大小、靶向治疗和糖尿病。列线图对3年和5年生存率显示出强大的预测准确性,尽管1年校准曲线显示一致性有限。尽管与初始样本相比外部验证性能略有下降,但该模型仍保持较强的预测能力。
营养炎症指数是卵巢癌患者OS和CSS的关键独立预后标志物。基于PNI和NPS的列线图为术后管理提供了有价值的预后见解。将这些指标纳入临床实践可以改善患者分层并指导个性化治疗方案。