Abstract
Inflammation is a hallmark of cancer. In our recent Umbrella systematic review of systematic reviews, we demonstrated that inflammatory biomarkers based on peripheral blood count impact both progression-free survival and overall survival (OS) in ovarian cancer. Pan-Immune-Inflammation Value (PIIV) is a new prognostic factor that was studied in breast cancer and other malignancies, but never in ovarian cancer. In this study, we provide the first results of the prognostic value of PIIV in a Moroccan cohort of ovarian cancer patients based on a biomarker-analysis of OVANORDEST-1 study. An exploratory biomarker set from our OVANORDEST-1 database was included in the final analysis with OS as a primary endpoint. PIIV was calculated as previously described: (neutrophil count × platelet count × monocyte count)/lymphocyte count. Receiver operating characteristic (ROC) was used to evaluate the optimal cut-off of PIIV. Cox proportional hazard model was used for multivariable analysis and Kaplan-Meier method to estimate OS. A total number of 158 patients treated for epithelial ovarian cancer with a median age of 55 years were included in the survival analysis. A ROC-based cut off of 991.7 of PIIV was used for patients’ stratification. Survival analysis using Log rank test showed a significant association of PIIV with OS (p<0.0001). Women with high PIIV had the worst outcomes as compared to those with low PIIV (median OS: 16 months versus 35.4 months, respectively). On Cox proportional hazard model, PIIV was an independent predictor of OS (HR=2.38, CI:1.47-3.85; p<0.0001). High PIIV is associated with an increased risk of death in women with epithelial ovarian cancer. A validation set of this study is ongoing and a prospective enrollment to develop a nomogram based on PIIV is being planned.
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