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

Xingyu Liu ^1,2, Ming Li ³, Yingjun Zhao ³

¹Department of Gynecological Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
²National Clinical Research Center for Obstetrics and Gynecology, Cancer Biology Research Center (Key Laboratory of the Ministry of Education), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430000, China.
³Department of Gynaecology and Obstetrics, Henan Provincial People's Hospital, Henan, China.
⁴National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
⁵Department of Gynecologic Oncology, Chongqing University Cancer Hospital, Chongqing, China.
⁶Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China.
⁷Key Laboratory for Biorheological Science and Technology of Ministry of Education (Chongqing University), Chongqing University Cancer Hospital, Chongqing, China.
⁸Department of Cancer Biology Immunotherapy, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, Henan, China.
⁹Department of Gynecologic Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong, China.
¹⁰Hunan Clinical Research Center in Gynecologic Cancer, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Changsha, Hunan, China.
¹¹Department of Gynecologic Cancer, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China.
¹²Department of Obstetrics and Gynecology, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China.
¹³Department of Gynecology & Obstetrics, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.
¹⁴Department of Gynecological Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. tinghu_tj@163.com.
¹⁵National Clinical Research Center for Obstetrics and Gynecology, Cancer Biology Research Center (Key Laboratory of the Ministry of Education), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430000, China. tinghu_tj@163.com.
¹⁶Department of Gynecological Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. qingleigao@hotmail.com.
¹⁷National Clinical Research Center for Obstetrics and Gynecology, Cancer Biology Research Center (Key Laboratory of the Ministry of Education), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430000, China. qingleigao@hotmail.com.

⁰Department of Gynecological Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Journal of Ovarian Research +

|

February 18, 2025

View abstract on PubMed

Summary

Poor preoperative immunonutritional status negatively impacts epithelial ovarian cancer prognosis. Optimizing nutritional and immune markers like the prognostic nutritional index (PNI) and systemic immune-inflammation index (SII) may improve patient survival outcomes.

Area Of Science

Oncology
Immunonutrition
Cancer Prognostics

Background

Epithelial ovarian cancer (EOC) prognosis is influenced by various patient factors.
Preoperative immunonutritional status is increasingly recognized as a critical determinant of cancer outcomes.

Purpose Of The Study

To evaluate the association between preoperative immunonutritional status and prognosis in epithelial ovarian cancer (EOC) patients.
To determine the predictive value of the prognostic nutritional index (PNI) and systemic immune-inflammation index (SII) in EOC.

Main Methods

A multicenter real-world study involving 922 EOC patients undergoing surgery.
Assessment of immunonutritional status using Prognostic Nutritional Index (PNI) and Systemic Immune-Inflammation Index (SII).
Cox regression analyses to identify prognostic factors for progression-free survival (PFS) and overall survival (OS).

Main Results

In early-stage EOC, high PNI correlated with improved PFS and OS, while high SII was linked to worse PFS.
In advanced-stage EOC, PNI and SII independently predicted overall survival (OS).
Specific optimal cut-off values for PNI and SII were identified for both early and late-stage cohorts.

Conclusions

Suboptimal preoperative immunonutritional status is detrimental to EOC patient prognosis.
Interventions targeting immunonutritional status in EOC patients may enhance survival.
PNI and SII serve as valuable indicators for predicting outcomes in EOC.

Keywords:

Ovarian cancer Overall survival Preoperative immunonutritional status Prognostic nutritional index Progression-free survival Systemic immune-inflammation index

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