Immuno-inflammatory-related vulnerabilities and high mortality risk among patients with aggressive early-onset epithelial ovarian cancers in West Africa: A retrospective study

Abstract

AbstractIntroductionThis study evaluated systemic immune-inflammatory indices (SIII) among patients with epithelial ovarian cancer (EOC) to identify affordable markers for disease assessment and treatment monitoring. This study did not assess the rate of BRCA2 mutation and SIII in early-onset (≤ 50 years old) and late-onset (> 50 years old) EOC but also evaluated SIII in treatment outcomes.MethodsThis study included 100 patients diagnosed with EOC from Jan. 2016 to Dec. 2021. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), platelets-neutrophils-to-lymphocytes ratio (PNLR), and neutrophils-to-lymphocytes platelets ratio (NLPR) were assessed and analyzed accordingly. Significance was set at p< 0.05.ResultThe frequency of early menarche, serous adenocarcinoma, and late-stage disease was 3.3, 1.6, and 1.4 times higher among patients with early-onset EOC compared with their late-onset counterparts (p= 0.001, 0.025, and 0.397, respectively). The frequency of BRCA2 mutation, hypertension, and diabetes was 2.5, 2.5, and 5.7 times higher among the latter than among the former (p= 0.001, 0.006, and 0.064, respectively). The pre-/post-treatment NLR and PNLR were 2.2/2.4 and 1.7/2.3 times higher among patients who died in the hospital than patients who were stable on discharge, respectively (p< 0.05). Although the pre-chemotherapy PNLR was 2.1 times higher among patients with stages I/II EOC compared with patients with stages III/IV EOC (p= 0.031), there was a 2.5 times significant decline and 1.1 times insignificant decline in pre-to-post-chemotherapy PNLR among the former and latter (p= 0.003 and 0.433, respectively). The post-treatment PNLR, PLR, and TWBC of herbal medicine-experienced patients were 5.6, 1.6, and 1.5, higher than the post-treatment values of naïve counterparts, respectively (p< 0.05).ConclusionThis study revealed a high frequency of late-onset EOC but poor chemotherapy response among patients with aggressive early-onset. It suggests that NLR, PNLR, and PLR could be used to monitor disease progression and treatment outcomes.