Fibrinolysis markers as predictive indicators of neoadjuvant chemotherapy efficacy in ovarian cancer patients
Ovarian cancer (OC) is a prevalent gynecological malignancy with high mortality due to its asymptomatic progression and advanced stage at diagnosis. Neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) is beneficial for patients unsuitable for primary debulking surgery (PDS). Effective markers for assessing NACT outcomes could significantly aid clinical decision-making and personalized treatment strategies. In this retrospective study, we examined fibrinolytic markers, including D-dimer, fibrinogen (FIB), and fibrinogen degradation products (FDP), among 167 OC patients and 110 healthy controls. Plasma levels of these markers were measured before and after four NACT cycles in OC patients, and receiver operating characteristic (ROC) analysis was conducted to evaluate their diagnostic and predictive value. OC patients exhibited significantly elevated baseline levels of D-dimer, FIB, and FDP compared to healthy controls. Post-NACT measurements showed that responders had a substantial decrease in these markers, while non-responders showed minimal changes. ROC analysis confirmed the diagnostic accuracy of D-dimer, FIB, and FDP, with high sensitivity and specificity for predicting NACT effectiveness. D-dimer, FIB, and FDP are elevated in OC patients and demonstrate a potential role as noninvasive markers for assessing NACT efficacy, offering valuable insights for treatment planning.