Prognostic Value of Combined Neutrophil-to-Lymphocyte Ratio and Prognostic Nutritional Index in Advanced Ovarian...

Background Inflammation- and nutrition-related biomarkers such as the neutrophil-to-lymphocyte ratio (NLR) and prognostic nutritional index (PNI) have been reported as prognostic factors for ovarian cancer. However, their clinical significance in patients treated with neoadjuvant chemotherapy (NAC) has not been fully elucidated. Methods We retrospectively analyzed 25 patients with advanced ovarian cancer accompanied by peritoneal dissemination who were deemed unsuitable for complete primary debulking surgery and subsequently underwent interval debulking surgery after NAC. They were classified into the complete (R0) and incomplete (R1) resection groups based on the postoperative residual tumor status. Associations of NLR, PNI, and their combination with progression-free survival (PFS) and overall survival (OS) were evaluated. Results Patients who achieved complete resection (R0) had significantly longer PFS and OS than those who achieved incomplete resection (R1) (P < 0.01). Neither NLR (<5 vs. ≥5) nor PNI (>35 vs. ≤35) alone was significantly associated with PFS or OS. In contrast, patients with a high NLR (≥5) combined with a low PNI (≤35) had significantly poorer PFS (P = 0.05) and OS (P = 0.03) than the remaining patients. Conclusions The combination of elevated NLR and decreased PNI may serve as a useful prognostic indicator for patients with advanced ovarian cancer treated with NAC. An integrated evaluation of inflammatory and nutritional statuses may contribute to improved risk stratification and clinical decision-making in this treatment setting.