Introduction/Background Blood inflammatory composite markers play significant role in the prognostication of various malignancies. Our study aims to assess the role of neutrophil-to-lymphocyte(NLR),platelet-to-lymphocyte(PLR), monocyte-to-lymphocyte(MLR)ratios and systemic inflammation index(SII) in determining progression free survival(PFS) in patients with advanced stage high grade serous ovarian cancer(HGSOC). Secondary outcomes include assessing their reliability in predicting the extension of the disease, the radicality of the surgery and the likelihood of achieving complete cytoreduction(CCR).

Methodology Consecutive patients with FIGO stage IIIC or IV HGSOC, treated with either primary or interval cytoreductive surgery and 6-cycles of chemotherapy at Northern Gynaecological Oncology Centre, Gateshead, UK in a 6-month period, were included in this pilot study. The study will be extended to a 5-year period. Departmental electronic records were used to obtain demographics and clinicopathological data including intra-operative findings, surgical outcomes and pre-treatment blood inflammatory composite markers. The operative notes were reviewed to establish Peritoneal Carcinomatosis Index(PCI) and the surgical complexity score(Aletti Score). The cut-off values of the ratios were established from the literature. These ratios were correlated with PFS by using Cox regression analyses and Kaplan-Meier method.

Results 34 patients were included; 26(76%) had primary cytoreductive surgery and adjuvant chemotherapy whilst 8(24%) had neo-adjuvant chemotherapy with interval cytoreductive surgery. The median PFS was 19.1(IQR 14.2–39.6)months. Using a univariate Cox regression, patients with high pre-treatment NLR, PLR and SII had a significantly shorter PFS(p=0.016, 0.002, 0.022 respectively). MLR was the only marker which significantly projected PCI score findings(p<0.01) and the radicality(Aletti Score >8) of surgery required(p=0.05). None of the blood inflammatory ratios showed a correlation in predicting the likelihood of achieving CCR.

Conclusion Intense follow-up pathways may be considered in patients with high NLR,PLR and SII after completion of their first line treatment. High MLR is significantly correlated with ultra-radical surgery and pre-operative planning with the appropriate surgical team should be considered.

Disclosures .