Associations between the prognostic nutritional index and response to neoadjuvant chemotherapy in patients with epithelial ovarian cancer

Objective: To evaluate the association between the prognostic nutritional index and the response to neoadjuvant chemotherapy in Mexican patients with epithelial ovarian cancer. Methods: Retrospective analyses of 220 patients with epithelial ovarian cancer treated with neoadjuvant therapy. The cutoff points for the prognostic nutritional index at diagnosis and after neoadjuvant therapy were determined via receiver operating characteristic curves. Categorical variables were analyzed with the χ² test, and multivariate analyses were performed with logistic regression. Disease-free survival and overall survival were analyzed via the Kaplan‒Meier method. Results: The median age was 55 years (range; 28-82). The most common histology was high-grade serous carcinoma in 199 cases (90.5%), and 66.4% (n = 146) were International Federation of Gynecology and Obstetrics stage IIIC. The prognostic nutritional index cutoff points at diagnosis and after neoadjuvant chemotherapy for complete or optimal cytoreduction were 40.5 and 45, respectively. High prognostic nutritional index values were associated with higher rates of complete or optimal cytoreduction: 53.6% and 67.7%, respectively. Additionally, high prognostic nutritional index values were associated with platinum sensitivity. According to the multivariate analysis, a high prognostic nutritional index value (OR 6.6, p = .001) was an independent factor associated with complete or optimal cytoreduction. The median overall survival at 3 years was not reached in patients with high prognostic nutritional index values (p = .054 and p = .015). Disease-free survival was not significantly different for high versus low prognostic nutritional index values (p = .9). Conclusions: The prognostic nutritional index may be used as an independent prognostic biomarker for advanced epithelial ovarian cancer.