Work

Association of Preoperative Systemic Inflammation Response Index and Neutrophil-to-Lymphocyte Ratio with Cytoreduction Outcomes in Ovarian Cancer: A Retrospective Cohort Study

Year: 2026

Type: article

Abstract: Purpose: Optimal cytoreduction is essential for improving outcomes in ovarian cancer, but reliable preoperative biomarkers for predicting surgical outcomes remain limited. This study aimed to evaluate the associations of preoperative systemic inflammation response index (SIRI) and neutrophil-to-lymphocyte ratio (NLR) with cytoreduction outcomes and assess their discriminatory performance in ovarian cancer. Patients and Methods: This single-center retrospective cohort study reviewed medical records of women who underwent debulking surgery at Hasan Sadikin General Teaching Hospital, Bandung, Indonesia, between January 2024 and December 2025. SIRI and NLR were calculated from preoperative complete blood count parameters. Separate multivariable logistic regression models were adjusted for age and histological group, with internal validation using 1000 bootstrap resamples. Surgical timing and prior systemic treatment status were not consistently documented, precluding reliable classification by surgical setting. Results: Among 107 patients, 57 had suboptimal and 50 had optimal cytoreduction. Median SIRI (2.34 vs 1.65, p = 0.047) and NLR (3.60 vs 3.01, p = 0.020) were higher in the suboptimal cytoreduction group. Individual biomarker AUCs were 0.611 (95% CI, 0.504-0.718) for SIRI and 0.631 (95% CI, 0.526-0.735) for NLR. In adjusted models, the estimated odds ratios per unit increase were 1.162 (95% CI, 1.001-1.349, p = 0.049) for SIRI and 1.188 (95% CI, 1.036-1.362, p = 0.014) for NLR. However, the overall likelihood-ratio test was significant only for the NLR model. The optimism-corrected AUCs of the multivariable models were 0.552 for SIRI and 0.587 for NLR. Conclusion: Preoperative SIRI and NLR were associated with cytoreduction outcomes, but both demonstrated limited discriminatory performance. The findings do not establish the superiority or clinical utility of either biomarker. Limited adjustment for clinical confounders and the absence of external validation warrant further prospective multicenter studies before clinical application.

Source: International Journal of Women s Health

DOI: 10.2147/ijwh.s655952

Authors: Deyane Maulin Azzahra, Dodi Suardi, Windi Nurdiawan

Institutions: Dr. Hasan Sadikin General Hospital, Padjadjaran University

Language: English

Topic: Inflammatory Biomarkers in Disease Prognosis

Subfield: Oncology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,836