The Prognosis Predictive Score around Neo Adjuvant Chemotherapy (PPSN) Improves Diagnostic Efficacy in Predicting the Prognosis of Epithelial Ovarian Cancer Patients

SIMPLE SUMMARY: A recent study conducted at our institution aimed to identify factors predicting prognosis for advanced epithelial ovarian cancer (EOC) patients who underwent pre-treatment inflammatory response analysis with pre-treatment and post-neo adjuvant chemotherapy (NACT). The study was conducted between June 2006 and March 2020, with demographic and clinicopathological data collected from 72 patients who underwent NACT followed by interval debulking surgery (IDS). The study created a novel predictive scoring system called the Predictive Prognosis Score around NACT (PPSN) using factors extracted from a receiver operating characteristic curve analysis. The study found that a high PPSN (≥4) significantly predicts poor prognosis, and CD3(+) and CD8(+) tumor-infiltrating lymphocytes in those with a low PPSN (<4) showed higher aggregation than those in high PPSN (≥4) cases. The study concluded that PPSN could be a useful prognostic tool for advanced EOC patients who undergo NACT followed by IDS. ABSTRACT: Background: Recent studies have shown that pretreatment inflammatory responses can predict prognosis. However, no reports have analyzed the combined effect of the inflammatory response with pre-treatment and post-neo adjuvant chemotherapy (NACT). This retrospective study aims to identify factors predicting prognosis and create a novel predictive scoring system. Methods: The study was conducted at our institution between June 2006 and March 2020. Demographic and clinicopathological data were collected from patients with advanced epithelial ovarian cancer who underwent neoadjuvant chemotherapy after sample collection by laparoscopic or laparotomy surgery, followed by interval debulking surgery. We created a scoring system, called the Predictive Prognosis Score around NACT (PPSN), using factors extracted from a receiver operating characteristic curve analysis. Univariate and multivariate analyses were conducted to assess the efficacy of PPSN in predicting progression-free survival and overall survival. Kaplan-Meier and log-rank tests were used to compare the PFS or OS rate. Results: Our study included 72 patients, with a cut-off value of four for the scoring system. Our analysis showed that high PPSN (≥4) significantly predicts poor prognosis. Moreover, CD3(+) and CD8(+) tumor-infiltrating lymphocytes with low PPSN (<4) showed higher aggregation than those with high PPSN (≥4) cases. Conclusion: Our study shows that PPSN could be a useful prognostic tool for advanced EOC patients who undergo NACT followed by IDS.