New prognostic index for neoadjuvant chemotherapy outcome in patients with advanced high-grade serous ovarian cancer

Abstract Background A validated prognostic index for the outcome of patients with advanced high-grade serous ovarian cancer (HGSOC) undergoing neoadjuvant chemotherapy (NACT) remains elusive. To address this need, we developed an ovarian neoadjuvant chemotherapy prognostic index (ONCPI) to improve p...

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Main Authors: Chuying Huo, Bin Wu, Dongdong Ye, Miaochun Xu, Shaolin Ma, Aoshuang Cheng, Yunyun Liu, Chunxian Huang, Yuhao Zhang, Zhongqiu Lin, Bowen Li, Huaiwu Lu
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Cancer
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Online Access:https://doi.org/10.1186/s12885-024-13324-0
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author Chuying Huo
Bin Wu
Dongdong Ye
Miaochun Xu
Shaolin Ma
Aoshuang Cheng
Yunyun Liu
Chunxian Huang
Yuhao Zhang
Zhongqiu Lin
Bowen Li
Huaiwu Lu
author_facet Chuying Huo
Bin Wu
Dongdong Ye
Miaochun Xu
Shaolin Ma
Aoshuang Cheng
Yunyun Liu
Chunxian Huang
Yuhao Zhang
Zhongqiu Lin
Bowen Li
Huaiwu Lu
author_sort Chuying Huo
collection DOAJ
description Abstract Background A validated prognostic index for the outcome of patients with advanced high-grade serous ovarian cancer (HGSOC) undergoing neoadjuvant chemotherapy (NACT) remains elusive. To address this need, we developed an ovarian neoadjuvant chemotherapy prognostic index (ONCPI) to improve predictive accuracy. Methods We encompassed an analysis of the clinicopathological characteristics of patients with advanced HGSOC who were administered platinum-based NACT. Blood inflammatory composite markers were calculated and converted into binary values using optimal cutoffs. Omental hematoxylin and eosin (H&E) stained slides were selected for the assessment of chemotherapy response score (CRS), which served as a measure of NACT efficacy. Logistic regression analysis and Cox proportional hazards regression model were utilized to construct a prognostic index. Results Multivariate logistic analysis showed that both CRS and neutrophil-to-lymphocyte ratio (NLR) independently influenced the response to platinum-based chemotherapy. Meanwhile, Kaplan–Meier and Cox regression analysis revealed that CRS score was significantly correlated with progression-free survival (PFS) and overall survival (OS), and patients with high NLR showed poor OS. We further developed an ovarian neoadjuvant chemotherapy prognostic index (ONCPI) based on the CRS and NLR. The area under the curve (AUC) value of ONCPI was 0.771 (P < 0.001, 95% CI: 0.656–0.887) for the prediction of platinum resistance. This AUC value surpasses that of the individual NLR and CRS, which were 0.670 (P = 0.018, 95% CI: 0.547–0.793) and 0.714 (P = 0.003, 95% CI: 0.590–0.839), respectively. Moreover, survival analysis suggested that patients with ONCPI of 0 and 1 were significantly associated with improved PFS and OS. Conclusions The ONCPI emerges as a significant prognostic marker for predicting NACT outcome in advanced HGSOC patients and holds promise for integration into clinical practice and risk-stratified trial design.
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spelling doaj-art-1cae777b2bc842d1abf68be6d7cc1caa2025-08-20T02:39:50ZengBMCBMC Cancer1471-24072024-12-0124111610.1186/s12885-024-13324-0New prognostic index for neoadjuvant chemotherapy outcome in patients with advanced high-grade serous ovarian cancerChuying Huo0Bin Wu1Dongdong Ye2Miaochun Xu3Shaolin Ma4Aoshuang Cheng5Yunyun Liu6Chunxian Huang7Yuhao Zhang8Zhongqiu Lin9Bowen Li10Huaiwu Lu11Department of Gynecologic Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen UniversityDepartment of Gynecologic Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen UniversityDepartment of Gynecologic Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen UniversityDepartment of Gynecology and Obstetrics, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Gynecologic Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen UniversityDepartment of Gynecologic Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen UniversityDepartment of Gynecologic Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen UniversityDepartment of Gynecologic Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen UniversityDepartment of Gynecologic Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen UniversityDepartment of Gynecologic Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen UniversityGuangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen UniversityDepartment of Gynecologic Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen UniversityAbstract Background A validated prognostic index for the outcome of patients with advanced high-grade serous ovarian cancer (HGSOC) undergoing neoadjuvant chemotherapy (NACT) remains elusive. To address this need, we developed an ovarian neoadjuvant chemotherapy prognostic index (ONCPI) to improve predictive accuracy. Methods We encompassed an analysis of the clinicopathological characteristics of patients with advanced HGSOC who were administered platinum-based NACT. Blood inflammatory composite markers were calculated and converted into binary values using optimal cutoffs. Omental hematoxylin and eosin (H&E) stained slides were selected for the assessment of chemotherapy response score (CRS), which served as a measure of NACT efficacy. Logistic regression analysis and Cox proportional hazards regression model were utilized to construct a prognostic index. Results Multivariate logistic analysis showed that both CRS and neutrophil-to-lymphocyte ratio (NLR) independently influenced the response to platinum-based chemotherapy. Meanwhile, Kaplan–Meier and Cox regression analysis revealed that CRS score was significantly correlated with progression-free survival (PFS) and overall survival (OS), and patients with high NLR showed poor OS. We further developed an ovarian neoadjuvant chemotherapy prognostic index (ONCPI) based on the CRS and NLR. The area under the curve (AUC) value of ONCPI was 0.771 (P < 0.001, 95% CI: 0.656–0.887) for the prediction of platinum resistance. This AUC value surpasses that of the individual NLR and CRS, which were 0.670 (P = 0.018, 95% CI: 0.547–0.793) and 0.714 (P = 0.003, 95% CI: 0.590–0.839), respectively. Moreover, survival analysis suggested that patients with ONCPI of 0 and 1 were significantly associated with improved PFS and OS. Conclusions The ONCPI emerges as a significant prognostic marker for predicting NACT outcome in advanced HGSOC patients and holds promise for integration into clinical practice and risk-stratified trial design.https://doi.org/10.1186/s12885-024-13324-0High-grade serous ovarian cancerNeoadjuvant chemotherapyPrognostic index
spellingShingle Chuying Huo
Bin Wu
Dongdong Ye
Miaochun Xu
Shaolin Ma
Aoshuang Cheng
Yunyun Liu
Chunxian Huang
Yuhao Zhang
Zhongqiu Lin
Bowen Li
Huaiwu Lu
New prognostic index for neoadjuvant chemotherapy outcome in patients with advanced high-grade serous ovarian cancer
BMC Cancer
High-grade serous ovarian cancer
Neoadjuvant chemotherapy
Prognostic index
title New prognostic index for neoadjuvant chemotherapy outcome in patients with advanced high-grade serous ovarian cancer
title_full New prognostic index for neoadjuvant chemotherapy outcome in patients with advanced high-grade serous ovarian cancer
title_fullStr New prognostic index for neoadjuvant chemotherapy outcome in patients with advanced high-grade serous ovarian cancer
title_full_unstemmed New prognostic index for neoadjuvant chemotherapy outcome in patients with advanced high-grade serous ovarian cancer
title_short New prognostic index for neoadjuvant chemotherapy outcome in patients with advanced high-grade serous ovarian cancer
title_sort new prognostic index for neoadjuvant chemotherapy outcome in patients with advanced high grade serous ovarian cancer
topic High-grade serous ovarian cancer
Neoadjuvant chemotherapy
Prognostic index
url https://doi.org/10.1186/s12885-024-13324-0
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