Köse Osman, Köse Elif, Gök Koray, Bostancı Mehmet Sühha
Department of Gynecologic Oncology, Sakarya University Faculty of Medicine, 54290 Adapazarı, Sakarya, Turkey.
Department of Public Health, Sakarya University Faculty of Medicine, 54290 Adapazarı, Sakarya, Turkey.
Cancers (Basel). 2025 Mar 27;17(7):1124. doi: 10.3390/cancers17071124.
Cytoreductive surgery (CRS) is the most important treatment method that increases survival in advanced-stage ovarian cancer (OC) patients. However, complications after CRS are seen as a significant cause of morbidity and mortality. Preoperative risk assessment of patients is of great importance. In recent years, inflammatory markers have been the subject of many studies evaluating malignancy and surgical outcomes. Ca125, Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), Monocyte-lymphocyte ratio (MLR), systemic inflammation index (SII), and systemic inflammatory response index (SIRI) stand out as prognostic and predictive tools in malignancies. This study aims to evaluate the preoperative inflammatory markers in patients who underwent CRS for advanced-stage epithelial ovarian cancer and to investigate the predictive power of postoperative complications.
This retrospective study examines patients who underwent CRS due to advanced-stage epithelial OC at Sakarya University Training and Research Hospital between 2014 and 2023. Postoperative complications of the patients were graded according to the Clavien-Dindo classification (CDC); Ca125, NLR, PLR, SII, SIRI and MLR values were calculated using preoperative laboratory data, and the predictive values of inflammatory markers were analysed with ROC curves.
A significant relationship was found between complications with CDC ≥ 3 and NLR, PLR, MLR, SII, and SIRI. The AUC value of SII was calculated as 0.740 ( < 0.001), NLR as 0.719 ( = 0.001), PLR as 0.668 ( = 0.011), and SIRI as 0.651 ( = 0.022). SII stands out as the marker with the highest predictive power. SII is a strong marker in predicting postoperative complications, especially in advanced-stage OC patients.
It was shown that preoperative inflammation markers may be an effective method for predicting postoperative complications in advanced-stage OC patients undergoing CRS. These findings may contribute to optimising surgical management and reducing complications. In future studies, these markers should be evaluated in groups with more patients, and their predictive power should be investigated.
细胞减灭术（CRS）是提高晚期卵巢癌（OC）患者生存率的最重要治疗方法。然而，CRS后的并发症被视为发病和死亡的重要原因。对患者进行术前风险评估至关重要。近年来，炎症标志物一直是许多评估恶性肿瘤和手术结果研究的主题。癌抗原125（Ca125）、中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、单核细胞与淋巴细胞比值（MLR）、全身炎症指数（SII）和全身炎症反应指数（SIRI）在恶性肿瘤中作为预后和预测工具备受关注。本研究旨在评估接受CRS治疗的晚期上皮性卵巢癌患者的术前炎症标志物，并探讨其对术后并发症的预测能力。
这项回顾性研究考察了2014年至2023年期间在萨卡里亚大学培训与研究医院因晚期上皮性OC接受CRS治疗的患者。根据Clavien-Dindo分类法（CDC）对患者的术后并发症进行分级；使用术前实验室数据计算Ca125、NLR、PLR、SII、SIRI和MLR值，并通过受试者工作特征曲线（ROC曲线）分析炎症标志物的预测价值。
发现CDC≥3级并发症与NLR、PLR、MLR、SII和SIRI之间存在显著相关性。SII的曲线下面积（AUC）值计算为0.740（P<0.001），NLR为0.719（P = 0.001），PLR为0.668（P = 0.011），SIRI为0.651（P = 0.022）。SII是预测能力最强的标志物。SII在预测术后并发症方面是一个强有力的标志物，尤其是在晚期OC患者中。
结果表明，术前炎症标志物可能是预测接受CRS治疗的晚期OC患者术后并发症的有效方法。这些发现可能有助于优化手术管理并减少并发症。在未来的研究中，应在更多患者群体中评估这些标志物，并研究其预测能力。
