Relationship Between Neoadjuvant Chemotherapy and Log Odds of Positive Lymph Nodes and Their Prognostic Role in Advanced Ovarian Cancer Patients With Optimal Cytoreductive Surgery

Hou, Yue-min; Xue, Yan; Yao, Jin-meng; Feng, Fang; An, Ruifang

doi:10.3389/fonc.2022.878275

Cited by 6 publications

(10 citation statements)

References 38 publications

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“…Hence, reducing the mortality of these patients is key to reducing the overall mortality of ovarian cancer patients. At present, patients with stage III ovarian cancer are often treated with neoadjuvant chemotherapy combined with interval debulking surgery (2)(3)(4). Chemotherapy has a significant curative effect on multiple malignant tumors (5,6), and patients who achieve complete response after neoadjuvant chemotherapy have better outcomes.…”

Section: Introductionmentioning

confidence: 99%

Predictive value of the systemic immune-inflammation index for the efficacy of neoadjuvant chemotherapy and prognosis in patients with stage III ovarian cancer—a retrospective cohort study

Wang¹,

Yin²,

Chen³

2022

Gland Surg

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Background: The systemic immune-inflammation index (SII) has been proven to be related to the prognoses of multiple malignant tumors. However, there are still few studies on the relationship between the SII and the effect of neoadjuvant chemotherapy in patients with ovarian cancer. It is of great significance to predict the efficacy of neoadjuvant chemotherapy in patients with ovarian cancer. Our study was aimed at determining the predictive value of the SII for the efficacy of neoadjuvant chemotherapy and prognosis in patients with stage III ovarian cancer.Methods: A total of 102 patients with stage III ovarian cancer treated in Tongji Hospital of Tongji University from January 2017 to January 2019 were retrospectively collected. According to the level of the SII before neoadjuvant chemotherapy, patients were divided into the high SII group and low SII group. We compared the effect of neoadjuvant chemotherapy between the 2 groups, and observed the progression-free survival and mortality of patients in the 2 groups after 3 years follow-up.Results: Compared with patients in the low SII group, the complete response rate of patients in the high SII group decreased significantly after neoadjuvant chemotherapy (13.73% vs. 45.10%, P=0.001), and the progressive disease rate increased (19.61% vs. 1.96%, P=0.011). The SII had certain value in predicting the inefficacy of neoadjuvant chemotherapy in patients with stage III ovarian cancer, and the area under the curve was 0.655 (95% CI: 0.548-0.762, P=0.007). The progression-free survival of patients in the high SII group was shorter than that of patients in the low SII group (P<0.001), and the overall survival rate of patients in the high SII group was lower (47.06% vs. 70.59%, P=0.016). The SII had predicting value for the postoperative death of ovarian cancer patients after neoadjuvant chemotherapy, and the area under the curve was 0.646 (95% CI: 0.537-0.756, P=0.012). Multivariate regression analysis showed that higher SII was a risk factor for death in ovarian cancer patients after neoadjuvant chemotherapy (OR: 2.700, P=0.017).Conclusions: A high SII was a predictor of inefficacy of neoadjuvant chemotherapy in patients with stage III ovarian cancer and was related to poor prognosis.

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Section: Introductionmentioning

confidence: 99%

Predictive value of the systemic immune-inflammation index for the efficacy of neoadjuvant chemotherapy and prognosis in patients with stage III ovarian cancer—a retrospective cohort study

Wang¹,

Yin²,

Chen³

2022

Gland Surg

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“…Several studies have found that the prognosis of patients with OC initially treated with NACT was not inferior to those treated with primary debulking surgery (PDS) [34,35]. Conversely, other studies have found no survival bene t or, in fact, an even worse prognosis in patients treated with NACT compared to PDS [36,37]. According to the primary treatment guidelines for OC developed by the Society of Gynecologic Oncology and the American Society of Clinical Oncologists, women with a high perioperative risk or a low likelihood of cytoreduction to residual lesions < 1 cm (ideally without signi cant lesions) should receive NACT [38].…”

Section: Discussionmentioning

confidence: 99%

“…Ovarian cancer (OC) is a common malignancy that ranks 1st among gynecologic cancers and 5th overall in the rate of cancer causing deaths in women [1]. In 2020, there were 313,959 new cases and 207,252 deaths as a result of OC in 185 countries worldwide, while 17.63% (55,342) of the global new cases, and 18.10% (37,519) of the global deaths were in China [2]. Due to the lack of effective screening methods and speci c symptoms, 60% of patients with OC are at an advanced stage at their rst diagnosis (34% in stage III or 26% in stage IV), even up to 80% of them with serous OC (51% in stage III or 29% in stage IV) [3].…”

Section: Introductionmentioning

confidence: 99%

The use of homologous recombination deficiency (HRD) scores in predicting the prognosis of ovarian cancer

Wu,

Huo,

et al. 2023

Preprint

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Objective:Predicting the early recurrence rate is important in improving the treatment and prognosis of ovarian cancer (OC). A homologous recombination deficiency (HRD) score serves as a prognostic factor in OC. Whether the HRD score can be used as a new marker for OC prognosis must be further explored. Methods: 69 patients with OC were enrolled in the study. We performed retrospective HRD genetic tests to obtain their HRD scores. The correlation test for tumor recurrence was performed using the Kaplan-Meier test and a Cox risk regression analysis. Results: No significant difference was found between the HRD score and the recurrence rate at the 1-year and full-time follow-up, rate of platinum-resistant recurrence. However, we demonstrated a strong association between the HRD score and hemoglobin (Hb) levels (P=0.004). Interestingly, Hb levels before initial cancer treatment (P=0.046) and neoadjuvant chemotherapy (NACT) (P=0.040) displayed independent influences on the 1-year recurrence rate. The 1-year recurrence rate was significantly higher in patients with low Hb levels (≤107 g/L) than in patients with high Hb levels (>107 g/L). Besides, it was significantly higher in patients who underwent NACT (based on high Suidan scores) than in patients who did not. Moreover, recurrence curves showed a significant association between NACT and the 1-year recurrence rate. Conclusions: For non-maintenance-treated patients, there is insufficient evidence that the HRD score can be used as a marker of short-term prognosis in OC. Hb levels and Suidan scores are expected to be new markers for predicting the 1-year recurrence rate in OC.

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“…However, these studies neither has a small sample size nor cover full aspects of ovarian cancer. Last but not least, the decision to perform lymphadenectomy was determined by the surgeon's discretion without any other objective criteria (23,24), or it depended on the policy of the hospital whether lymph node excision was performed (25).…”

Section: Discussionmentioning

confidence: 99%

Prognostic effect of lymphadenectomy extent on ovarian cancer：A population-based analysis

Wang

et al. 2022

Preprint

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Background Lymph node metastasis has a significant contribution to the prognosis of ovarian cancer but the role of lymphadenectomy is controversial in many previous studies. In this study, we aimed to retrospectively determine the effect of lymph nodes removed on survival. Methods Based on the surveillance, epidemiology, and end results registry (SEER) database, we included ovarian cancer patients with detailed information from 1973 to 2014. We performed a large population-based study to evaluate the role of lymphadenectomy in patients with ovarian cancer. Cox regression was conducted to select the impact factors of prognosis of ovarian cancer underwent lymphadenectomy. Our study analyzed the overall and cause specific survival of 61,169 patients diagnosed with ovarian cancer to determine the impact of the extent of the lymphadenectomy on prognosis and also evaluated the prognostic significance stratified on demographic and clinic pathological characteristics. Results The 5- year overall survival (OS) rates were 39.0%, 55.9% and 67.4% for no lymph nodes, 1 ~ 9 nodes, 10 ~ nodes, respectively (p < 0.001). For cause-specific survival (CSS), they were 39.8%, 58.5% and 70%, respectively (p < 0.001). Multivariate Cox model was used to investigate the role of lymphadenectomy in ovarian cancer on OS and CSS and the results indicated lymphadenectomy had beneficial effect on OS (1 ~ 9 nodes: HR = 0.69, 95% CI: 0.68 ~ 0.71, p < 0.001; 10 ~ nodes:HR = 0.55, 95% CI: 0.53 ~ 0.57, p < 0.001) and CSS (1 ~ 9 nodes: HR = 0.68, 95% CI: 0.66 ~ 0.70, p < 0.001;10 ~ nodes:HR = 0.53, 95% CI: 0.51 ~ 0.54, p < 0.001) and with the increase in the number of lymph nodes, the prognostic effect was better. Furthermore, when stratified by age, marital status, race, stage, grade and histology, more resected nodes were associated with a greater OS and CSS in each stratification. Conclusions Lymphadenectomy was associated with more favorable outcomes in ovarian cancer patients undergoing surgery.

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Relationship Between Neoadjuvant Chemotherapy and Log Odds of Positive Lymph Nodes and Their Prognostic Role in Advanced Ovarian Cancer Patients With Optimal Cytoreductive Surgery

Cited by 6 publications

References 38 publications

Predictive value of the systemic immune-inflammation index for the efficacy of neoadjuvant chemotherapy and prognosis in patients with stage III ovarian cancer—a retrospective cohort study

Predictive value of the systemic immune-inflammation index for the efficacy of neoadjuvant chemotherapy and prognosis in patients with stage III ovarian cancer—a retrospective cohort study

The use of homologous recombination deficiency (HRD) scores in predicting the prognosis of ovarian cancer

Prognostic effect of lymphadenectomy extent on ovarian cancer：A population-based analysis

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