Combination of albumin-lymphocyte score and skeletal muscle index predicts prognosis of ovarian patients after primary debulking surgery: A multicenter retrospective study

Abstract

Background Accumulating evidence underscores the significant aspects of inflammation and nutrition in the tumors. We aimed to assess related prognostic preoperative variables and their combined impact for ovarian cancer patients. Methods A retrospective research was proceeded among 347 primarily diagnosed ovarian cancer patients across multiple medical centers. They were divided into a discovery cohort (237 patients) and a validation cohort (110 patients). Serological tests and plain CT images were utilized to quantify ALS and SMI. We intended to inspect the impact of ALS, SMI, and their combined indicator-CAS grade on clinical features and prognosis of the patients. Results Patients illustrating decreased ALS and increased SMI demonstrated improved overall survival (OS) and recurrence-free survival (RFS). Upon stratification by CAS grade, distinct results were observed: grade 1 patients displayed higher body mass index (BMI) and the most favorable survival prognosis, while grade 3 patients were in connection with poorest OS and RFS. Independent variables for OS and RFS included residual disease and elevated CAS grades. These findings were also validated in another independent cohort. Conclusion The CAS grade - combination of ALS and SMI is a ponderable and independent predictor for prognosis in ovarian cancer patients.