Prognostic significance of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in predicting response to neoadjuvant chemotherapy in advanced high-grade serous ovarian cancer: a prospective study
To evaluate whether the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) can predict pathological and clinical responses to neoadjuvant chemotherapy (NACT) in patients with advanced-stage high-grade serous ovarian carcinoma (HGSOC). In this prospective cohort study, 80 patients with FIGO stage III-IV HGSOC received three cycles of platinum-based neoadjuvant chemotherapy. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were measured before and after the neoadjuvant treatment. Treatment response was evaluated using RECIST 1.1, chemotherapy response score (CRS), and the Completeness of cytoreduction score (CC score). The associations between these inflammatory markers and outcomes were analyzed using appropriate statistical tests. Following neoadjuvant chemotherapy, patients who achieved a good histopathological response (CRS 3) showed significantly lower baseline and post-NACT NLR and PLR values compared to those with CRS 1-2 (p < 0.001). Baseline NLR > 5.5 (Sensitivity: 94.7 %, Specificity: 86.9 %), PLR > 177 (Sensitivity: 94.7 %, Specificity: 88.5 %) predicted poor histopathological response (CRS1). Pre- and post-NACT NLR and PLR may serve as valuable, non-invasive biomarkers for predicting histopathologic response to chemotherapy in advanced serous ovarian carcinoma. Incorporating these inflammatory markers into preoperative assessment may improve patient stratification and surgical planning.