Serum D-dimer, albumin and systemic inflammatory response markers in ovarian clear cell carcinoma and their prognostic implications

Wei Chen,Huijuan Yang,Xiaohua Wu,Siyuan Zhong,Boer Shan,Shuling Zhou,Shuang Ye

doi:10.1186/s13048-020-00693-w

Abstract

BackgroundThis study attempts to evaluate whether preoperative systemic inflammatory response (SIR) markers or other hematological variables, such as albumin, D-dimer, and carbohydrate antigen 125, play roles in predicting chemotherapy response and survival outcome in patients with ovarian clear cell carcinoma (OCCC).MethodsPreoperative leukocyte differential counts, as well as platelet, serum albumin, plasma D-dimer and CA-125 levels, were measured in patients with FIGO IC-IV ovarian clear cell cancer. The correlations of these hematological biomarkers with clinicopathological features, chemotherapy response, and survival outcomes were further analyzed. Survival time was estimated using the Kaplan-Meier model, whereas Cox regression was conducted for multivariate analysis.ResultsAmong the 84 patients, 28.6% were classified as platinum resistant, and 69.0% were platinum sensitive. Preoperative CA125, albumin, and D-dimer levels; neutrophil to lymphocyte ratios (NLR); and monocyte to lymphocyte ratios were significantly correlated with FIGO stage, residual tumor, and platinum response. Platelet to lymphocyte ratio was not related to platinum response (P = 0.060). The median follow-up time was 28 months (range, 1 to 128 months). Preoperative CA125, albumin, and D-dimer levels were significant prognostic factors for overall survival (OS) and progression-free survival (PFS). In the univariate analysis, only NLR exhibited prognostic significance for PFS (P = 0.007). Multivariate analysis indicated that D-dimer > 3.27 (P = 0.001 for OS; P = 0.040 for PFS) and albumin < 39.6 (P = 0.005 for OS and P = 0.041 for PFS) retained significance.ConclusionsPreoperative NLR has some predictive value for platinum resistance in patients with IC-IV stage OCCC but has little predictive effect on prognosis. Elevated D-dimer and reduced albumin might be potential biomarkers for worse response to first-line platinum-based chemotherapy and poor clinical outcomes.

Highlights

This study attempts to evaluate whether preoperative systemic inflammatory response (SIR) markers or other hematological variables, such as albumin, HR hazard ratio (D-dimer), and carbohydrate antigen 125, play roles in predicting chemotherapy response and survival outcome in patients with ovarian clear cell carcinoma (OCCC)
The purpose of the current study was to determine whether preoperative hematological biomarkers, such as albumin, Ddimer, and carbohydrate antigen 125 (CA125), or SIR markers could play a role in predicting response to chemotherapy and survival outcome
Prognostic factors influencing long-term survival with platinum-based chemotherapy We found that preoperative CA125, albumin, and Ddimer levels were significant prognostic indicators for overall survival (OS) and progression-free survival (PFS)

Summary

Introduction

This study attempts to evaluate whether preoperative systemic inflammatory response (SIR) markers or other hematological variables, such as albumin, D-dimer, and carbohydrate antigen 125, play roles in predicting chemotherapy response and survival outcome in patients with ovarian clear cell carcinoma (OCCC). The prognosis for patients with stage I OCCC is relatively good, patients with stage IC-IV OCCC presents much poorer prognoses than patients with serous carcinoma due to its disease aggressiveness and chemotherapy resistance [3, 4]. The factors, such as the International Federation of Gynecology and Obstetrics (FIGO) stage, residual tumor, and platinum response, influence treatment outcomes in OCCC [5]. These factors are limited to be confirmed after surgery or chemotherapy.

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