The impact of preoperative immunonutritional status on prognosis in ovarian cancer: a multicenter real-world study.

IF 4.2 3区医学 Q1 REPRODUCTIVE BIOLOGY Journal of Ovarian Research Pub Date : 2025-02-17 DOI:10.1186/s13048-025-01607-4

Xingyu Liu, Ming Li, Yingjun Zhao, Xiaofei Jiao, Yang Yu, Ruyuan Li, Shaoqing Zeng, Jianhua Chi, Guanchen Ma, Yabing Huo, Zikun Peng, Jiahao Liu, Qi Zhou, Dongling Zou, Li Wang, Qingshui Li, Jing Wang, Shuzhong Yao, Youguo Chen, Ding Ma, Ting Hu, Qinglei Gao

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Abstract

Background: To investigate the effect of preoperative immunonutritional status on prognosis in epithelial ovarian cancer patients.

Methods: A multicenter real-world study included 922 patients with histologically confirmed epithelial ovarian cancer who received comprehensive staged surgery or debulking surgery at seven tertiary hospitals in China between 2012 and 2023. Prognostic nutritional index (PNI) and systemic immune-inflammation index (SII) were used to assess the immunonutritional status for their superior predictive power to indicate the nutritional status and the inflammatory immunity. Cox regression analyses were employed to identify variables associated with progression-free survival (PFS) and overall survival (OS).

Results: In the early-stage cohort of 224 epithelial ovarian cancer patients, the optimal cut-off value for PNI was 47.47 for both PFS and OS, while the optimal cut-off value for SII values were 551.37 for PFS and 771.78 for OS. In the late-stage group of 698 patients, the optimal PNI thresholds were 47.76 for PFS and 46.00 for OS, with SII values of 720.96 for PFS and 1686.11 for OS. In multivariate analysis of early-stage patients, high PNI was an independent protective factor for PFS (hazard ratio (HR), 0.39 (95% confidence interval (CI) 0.20-0.76), P = 0.006) and OS (HR, 0.44 (95% CI 0.20-0.97), P = 0.042), respectively. High SII was significantly associated with PFS (HR, 2.43 (95% CI 1.23-4.81), P = 0.011) and marginally unfavorable for OS (HR, 2.05 (95% CI 0.96-4.39), P = 0.064). In advanced population, PNI (HR, 0.77 (95% CI 0.60-0.99), P = 0.043) and SII (HR, 1.34 (95% CI 1.01-1.78), P = 0.041) were independent prognostic factors for OS but had no impact on PFS (P = 0.185, P = 0.188, respectively).

Conclusion: Poor preoperative immunonutritional status has a deleterious effect on the prognosis of patients with ovarian cancer. Intervention in patients suffering from suboptimal preoperative immunonutritional status may facilitate improved survival outcomes.

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卵巢癌术前免疫营养状况对预后的影响：一项多中心现实世界研究。

背景：探讨上皮性卵巢癌患者术前免疫营养状况对预后的影响。方法：一项多中心现实世界研究纳入了922例组织学证实的上皮性卵巢癌患者，这些患者于2012年至2023年在中国7家三级医院接受了全面分期手术或减体积手术。采用预后营养指数（PNI）和全身免疫-炎症指数（SII）评价免疫营养状况，对营养状况和炎症免疫有较好的预测能力。采用Cox回归分析确定与无进展生存期（PFS）和总生存期（OS）相关的变量。结果：在224例上皮性卵巢癌患者的早期队列中，PFS和OS的PNI最佳临界值为47.47，而PFS和OS的SII最佳临界值分别为551.37和771.78。在698例晚期患者中，PFS组最佳PNI阈值为47.76，OS组为46.00，PFS组SII值为720.96，OS组为1686.11。在早期患者的多因素分析中，高PNI是PFS（风险比0.39(95%可信区间CI 0.20 ~ 0.76), P = 0.006）和OS（风险比0.44 (95% CI 0.20 ~ 0.97), P = 0.042）的独立保护因素。高SII与PFS显著相关（HR, 2.43 (95% CI 1.23-4.81), P = 0.011），对OS不利（HR, 2.05 (95% CI 0.96-4.39), P = 0.064）。在晚期人群中，PNI （HR, 0.77 (95% CI 0.60-0.99), P = 0.043）和SII （HR, 1.34 (95% CI 1.01-1.78), P = 0.041）是OS的独立预后因素，但对PFS没有影响（P = 0.185, P = 0.188）。结论：术前不良的免疫营养状况对卵巢癌患者的预后有不良影响。对术前免疫营养状况不佳的患者进行干预可能有助于改善生存结果。

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来源期刊

Journal of Ovarian Research REPRODUCTIVE BIOLOGY-

CiteScore

6.20

自引率

2.50%

发文量

125

审稿时长

>12 weeks

期刊介绍： Journal of Ovarian Research is an open access, peer reviewed, online journal that aims to provide a forum for high-quality basic and clinical research on ovarian function, abnormalities, and cancer. The journal focuses on research that provides new insights into ovarian functions as well as prevention and treatment of diseases afflicting the organ. Topical areas include, but are not restricted to: Ovary development, hormone secretion and regulation Follicle growth and ovulation Infertility and Polycystic ovarian syndrome Regulation of pituitary and other biological functions by ovarian hormones Ovarian cancer, its prevention, diagnosis and treatment Drug development and screening Role of stem cells in ovary development and function.