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Abstract
Introduction/Background Advanced Lung Cancer Inflammation Index (ALI) reflects systemic inflammation and has been shown to be a prognostic factor for lung cancer patients undergoing surgery. No previous study has assessed the prognostic significance of ALI in patients with ovarian cancer (OC). This study aimed to explore the relationship between ALI and prognosis of OC.
Methodology Electronic records of 83 patients with OC who underwent primary debulking surgery (PDS) at Tata Medical Center between 2017 and 2018 were reviewed. Patients treated with primary chemotherapy and those treated with palliative intent were excluded. The ALI score was calculated as body mass index x serum albumin/neutrophil to lymphocyte ratio. A web-based programme [Cutoff Finder (http://molpath.charite.de/cutoff/)] was used to deduce the appropriate cut-off value for ALI. The Kaplan-Meier method and Cox Proportional Hazards model were used to compare survival among prognostic groups.
Results The optimal cut-off value of ALI was determined as 12.5. Among the 83 patients, 10 had low ALI (<12.5), and 73 had high ALI (≥12.5). The low-ALI group had more complications of Clavien-Dindo grade 3 or higher after PDS (P=0.04). The patients with low ALI had higher chances of 30-day-mortality following PDS compared to the high-ALI group (P=.005). Median relapse-free survival (RFS) in the low-ALI group was 9 months compared to 32 months in the high-ALI group (hazard ratio [HR] for relapse, 0.16; P <0.001). Median overall survival (OS) in the low-ALI group was 20 months, and in the high-ALI group median OS was 56 months (HR 0.12, P<0.001).
Conclusion Low ALI was associated with higher perioperative complications and poorer survival in ovarian cancer. The utility of preoperative ALI as a prognostic marker in ovarian cancer should be assessed in prospective studies.