Association of Preoperative Systemic Inflammation Response Index and Neutrophil-to-Lymphocyte Ratio with Cytoreduction Outcomes in Ovarian Cancer: A Retrospective Cohort Study
- 1Department of Obstetrics and Gynecology, Hasan Sadikin General Teaching Hospital, Faculty of Medicine, Padjadjaran University, Bandung, West Java, Indonesia
- 2Gynecologic Oncology Division, Department of Obstetrics and Gynecology, Hasan Sadikin General Teaching Hospital, Faculty of Medicine, Padjadjaran University, Bandung, West Java, Indonesia
- 3Social Obstetrics and Gynecology Division, Department of Obstetrics and Gynecology, Hasan Sadikin General Teaching Hospital, Faculty of Medicine, Padjadjaran University, Bandung, West Java, Indonesia
Abstract
Purpose: Optimal cytoreduction is essential for improving outcomes in ovarian cancer, but reliable preoperative biomarkers for predicting surgical outcomes remain limited. This study aimed to evaluate the associations of preoperative systemic inflammation response index (SIRI) and neutrophil-to-lymphocyte ratio (NLR) with cytoreduction outcomes and assess their discriminatory performance in ovarian cancer.
Patients and Methods: This single-center retrospective cohort study reviewed medical records of women who underwent debulking surgery at Hasan Sadikin General Teaching Hospital, Bandung, Indonesia, between January 2024 and December 2025. SIRI and NLR were calculated from preoperative complete blood count parameters. Separate multivariable logistic regression models were adjusted for age and histological group, with internal validation using 1000 bootstrap resamples. Surgical timing and prior systemic treatment status were not consistently documented, precluding reliable classification by surgical setting.
Results: Among 107 patients, 57 had suboptimal and 50 had optimal cytoreduction. Median SIRI (2.34 vs 1.65, p = 0.047) and NLR (3.60 vs 3.01, p = 0.020) were higher in the suboptimal cytoreduction group. Individual biomarker AUCs were 0.611 (95% CI, 0.504–0.718) for SIRI and 0.631 (95% CI, 0.526–0.735) for NLR. In adjusted models, the estimated odds ratios per unit increase were 1.162 (95% CI, 1.001–1.349, p = 0.049) for SIRI and 1.188 (95% CI, 1.036–1.362, p = 0.014) for NLR. However, the overall likelihood-ratio test was significant only for the NLR model. The optimism-corrected AUCs of the multivariable models were 0.552 for SIRI and 0.587 for NLR.
Conclusion: Preoperative SIRI and NLR were associated with cytoreduction outcomes, but both demonstrated limited discriminatory performance. The findings do not establish the superiority or clinical utility of either biomarker. Limited adjustment for clinical confounders and the absence of external validation warrant further prospective multicenter studies before clinical application.
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BibTeX
@article{azzahra2026association,
title = {{Association of Preoperative Systemic Inflammation Response Index and Neutrophil-to-Lymphocyte Ratio with Cytoreduction Outcomes in Ovarian Cancer: A Retrospective Cohort Study}},
author = {Deyane Maulin Azzahra and Dodi Suardi and Windi Nurdiawan},
journal = {International Journal of Women's Health},
year = {2026},
month = nov,
doi = {10.2147/ijwh.s655952},
url = {https://doi.org/10.2147/ijwh.s655952},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Association of Preoperative Systemic Inflammation Response Index and Neutrophil-to-Lymphocyte Ratio with Cytoreduction Outcomes in Ovarian Cancer: A Retrospective Cohort Study
AU - Deyane Maulin Azzahra
AU - Dodi Suardi
AU - Windi Nurdiawan
PY - 2026
DA - 2026/11/05
JO - International Journal of Women's Health
DO - 10.2147/ijwh.s655952
UR - https://doi.org/10.2147/ijwh.s655952
AB - Purpose: Optimal cytoreduction is essential for improving outcomes in ovarian cancer, but reliable preoperative biomarkers for predicting surgical outcomes remain limited. This study aimed to evaluate the associations of preoperative systemic inflammation response index (SIRI) and neutrophil-to-lymphocyte ratio (NLR) with cytoreduction outcomes and assess their discriminatory performance in ovarian cancer. Patients and Methods: This single-center retrospective cohort study reviewed medical records of women who underwent debulking surgery at Hasan Sadikin General Teaching Hospital, Bandung, Indonesia, between January 2024 and December 2025. SIRI and NLR were calculated from preoperative complete blood count parameters. Separate multivariable logistic regression models were adjusted for age and histological group, with internal validation using 1000 bootstrap resamples. Surgical timing and prior systemic treatment status were not consistently documented, precluding reliable classification by surgical setting. Results: Among 107 patients, 57 had suboptimal and 50 had optimal cytoreduction. Median SIRI (2.34 vs 1.65, p = 0.047) and NLR (3.60 vs 3.01, p = 0.020) were higher in the suboptimal cytoreduction group. Individual biomarker AUCs were 0.611 (95% CI, 0.504–0.718) for SIRI and 0.631 (95% CI, 0.526–0.735) for NLR. In adjusted models, the estimated odds ratios per unit increase were 1.162 (95% CI, 1.001–1.349, p = 0.049) for SIRI and 1.188 (95% CI, 1.036–1.362, p = 0.014) for NLR. However, the overall likelihood-ratio test was significant only for the NLR model. The optimism-corrected AUCs of the multivariable models were 0.552 for SIRI and 0.587 for NLR. Conclusion: Preoperative SIRI and NLR were associated with cytoreduction outcomes, but both demonstrated limited discriminatory performance. The findings do not establish the superiority or clinical utility of either biomarker. Limited adjustment for clinical confounders and the absence of external validation warrant further prospective multicenter studies before clinical application.
SN - 1179-1411
ER -