Speakers - 2026

Abstract

Objective: To investigate the correlation between immune-inflammatory markers such as PLR, NLR, LMR, SII, PNI and the tumor marker CA125  during neoadjuvant chemotherapy with the surgical outcome in patients with advanced epithelial ovarian cancer.

Methods: A retrospective analysis was conducted on the clinical data of 92 patients with advanced epithelial ovarian cancer who underwent neoadjuvant chemotherapy followed by interval debulking surgery at the Gynecological Department of the Eastern Campus of the Fourth Hospital of Hebei Medical University between January 2018 and November 2023. The patients were divided into R0 group and non-R0 group based on the surgical outcome. Univariate and multivariate regression analyses were employed to examine the differences in PLR, NLR, LMR, SII, PNI, and CA125 levels at different treatment nodes during neoadjuvant chemotherapy between the two groups.

Results: Among the 92 patients with advanced epithelial ovarian cancer, 63 achieved R0 cytoreduction (R0 group), while 29 did not achieve R0 resection (non-R0 group). Serum CA125 levels and the rate of CA125 decline, NLR levels and the rate of NLR decline, PNI values after the first cycle of neoadjuvant chemotherapy, preoperative serum CA125 levels, and the overall rate of CA125 decline were significantly associated with the achievement of R0 cytoreduction, showing statistically significant differences between the two groups (P < 0.05). The PNI value after the first cycle of neoadjuvant chemotherapy was identified as an independent predictive factor for achieving R0 cytoreduction (P < 0.05).  ROC curve analysis revealed that the overall rate of CA125 decline had the best predictive ability for R0 cytoreduction, with a cut-off value of 95.19%. When the overall rate of CA125 decline during neoadjuvant chemotherapy was ≥95.19%, the likelihood of achieving R0 cytoreduction was as high as 91.30%. The follow-up period for this study concluded on December 31, 2024.  Univariate analysis revealed that the rate of CA125 decline and NLR values after the first cycle of neoadjuvant chemotherapy were correlated with postoperative recurrence in patients with advanced epithelial ovarian cancer (P < 0.05).

Conclusion: The PNI value after the first cycle of neoadjuvant chemotherapy is an independent predictive factor for R0 cytoreduction. The combined assessment of the rate of CA125 decline, NLR levels, and PNI levels after the first cycle of NACT can help determine the feasibility of continuing chemotherapy and guide the optimization of treatment plans. The overall rate of CA125 decline after neoadjuvant chemotherapy has the best predictive ability for R0 cytoreduction. . Early monitoring of CA125 levels and their decline rates, PNI, NLR values during neoadjuvant chemotherapy is of guiding significance for the preliminary assessment of chemotherapy efficacy, determining the feasibility of continuing chemotherapy and identifying the optimal timing for IDS.

Keywords: Advanced epithelial ovarian cancer, Peripheral blood inflammatory indicators, Efficacy of neoadjuvant chemotherapy, R0 cytoreduction, Progression-free survival