The importance of Delta prognostic nutrition index as an early success indicator of optimal cytoreductive surgery in epithelial ovarian cancer patients

Epithelial ovarian cancer (EOC) represents a significant cause of mortality among women with gynecological malignancies and is frequently diagnosed at an advanced stage. The role of inflammation and nutritional status in prognosis has prompted the evaluation of the Prognostic Nutritional Index (PNI) as a marker for surgical success and survival in EOC patients. This study aimed to investigate the relationship between preoperative, postoperative, and Delta-PNI values and the outcomes of optimal cytoreductive surgery (OCS) in EOC. A retrospective analysis was conducted on 255 patients with EOC, examining the early impact of PNI on surgical outcomes. PNI was calculated based on serum albumin levels and lymphocyte count. The study assessed the correlations between changes in PNI and the success of surgery, overall survival (OS), and progression-free survival (PFS). A higher preoperative PNI was associated with improved surgical success and better survival rates. Specifically, the OS in the OCS group was longer, averaging 104.89 ± 71.1 months, compared to 81.5 ± 72.04 months in the non-OCS group (p = 0.016). PFS was also longer in the OCS group, with a mean of 52.03 ± 52.13 months, versus 30.67 ± 44.5 months in the non-OCS group (p = 0.002). Delta-PNI proved to be a robust predictor of surgical success, with a Receiver Operating Characteristic (ROC) analysis yielding an Area Under the Curve (AUC) of 0.795 (p < 0.001), indicating high discriminative capability. Patients with a Delta-PNI above the optimal cut-off of 11.3 exhibited an extended PFS. The findings highlight the prognostic significance of PNI and Delta-PNI in EOC, suggesting that these metrics can significantly predict surgical success and survival outcomes. The Delta-PNI’s association with longer PFS emphasizes its potential utility in preoperative risk assessment and patient management for EOC.

Epithelial ovarian cancer; Prognostic nutritional index; Optimal cytoreductive surgery; Survival outcomes; Delta-PNI

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