Preoperative Immunonutritional Scores as Predictors of Mortality and Recurrence in Patients with Peritoneal Carcinomatosis Secondary to Serous Ovarian Cancer Undergoing Cytoreductive Surgery and HIPEC

Öz

Hyperthermic intraperitoneal chemotherapy (HIPEC) combined with cytoreductive surgery (CRS) has become an increasingly preferred treatment for women with ovarian cancer presenting with peritoneal involvement. However, due to the high morbidity of HIPEC, accurate preoperative patient selection is essential. This study aimed to evaluate the prognostic value of immunonutritional indices—CALLY (C-reactive protein, albumin, lymphocyte) and Prognostic Nutritional Index (PNI)—in predicting early mortality and recurrence in patients undergoing CRS and HIPEC. A retrospective analysis was conducted on 49 female patients. Low CALLY (<0.55) and PNI (<49) values were significantly associated with worse early mortality and disease-free survival (DFS). In receiver operating characteristic (ROC) analyses, CALLY and PNI showed strong predictive power with AUC values of 0.882 and 0.914, respectively. Kaplan-Meier survival curves demonstrated significantly reduced 3- and 6-month survival rates in patients with low scores.In conclusion, CALLY and PNI are easy-to-calculate, cost-effective, and clinically practical biomarkers that may improve patient selection for CRS and HIPEC and support the development of personalized perioperative care protocols.

Anahtar Kelimeler

• Ovarian cancer
• Cytoreduction
• HIPEC
• Peritoneal carcinomatosis
• Immunonutritional scores
• CALLY.

Sitoredüktif Cerrahi ve HİPEK Uygulanan Seröz Over Kanserine Sekonder Peritoneal Karsinomatozisli Hastalarda Preoperatif İmmünonütrisyonel Skorların Erken Mortalite ve Nüksü Öngörmedeki Rolü

Öz

Sıcak intraperitoneal kemoterapi (HIPEC) ve sitoredüktif cerrahi (CRS), peritoneal tutulumlu over kanserli kadınlarda giderek daha fazla kullanılan bir tedavi yöntemidir. Ancak HIPEC’in yüksek morbiditesi nedeniyle, doğru preoperatif hasta seçimi kritik önem taşımaktadır. Bu çalışma, immünonütrisyonel indeksler olan CALLY (C-reaktif protein, albümin, lenfosit) ve Prognostik Nutrisyonel İndeks (PNI)’in, HIPEC ve CRS uygulanan hastalarda erken mortalite ve nüks açısından prognostik değerini araştırmayı amaçlamaktadır. Retrospektif olarak değerlendirilen 49 kadın hastanın verileri incelenmiştir. Düşük CALLY (<0.55) ve PNI (<49) değerleri, erken mortalite ve hastalıksız sağkalımda (DFS) anlamlı kötüleşme ile ilişkilendirilmiştir. ROC analizlerinde CALLY için AUC 0.882, PNI için 0.914 olarak bulunmuş; her iki skor da çok değişkenli analizlerde bağımsız mortalite öngördürücüsü olarak saptanmıştır. Kaplan-Meier analizleri, düşük skorlu gruplarda 3 ve 6 aylık sağkalım oranlarının belirgin şekilde düşük olduğunu göstermiştir. Sonuç olarak, CALLY ve PNI gibi kolay hesaplanabilir ve maliyet etkin biyobelirteçler, CRS ve HIPEC uygulanacak hastaların seçiminde yardımcı olabilir ve kişiselleştirilmiş tedavi planlarının geliştirilmesine katkı sağlayabilir.

Anahtar Kelimeler

• Over kanseri
• Sitoredüksiyon
• HİPEK
• Peritoneal karsinmatoz
• İmmünonutriyonel skorlar
• CALLY.

Kaynakça

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