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. 2024 Sep 27;16(19):3295.
doi: 10.3390/cancers16193295.

The Predictive Value of the Fibrinogen-Albumin-Ratio Index on Surgical Outcomes in Patients with Advanced High-Grade Serous Ovarian Cancer

Magdalena Postl  1 , Melina Danisch  1 , Fridolin Schrott  1 , Paul Kofler  1 , Patrik Petrov  1 , Stefanie Aust  1 , Nicole Concin  1 , Stephan Polterauer  1 , Thomas Bartl  1
Affiliations

The Predictive Value of the Fibrinogen-Albumin-Ratio Index on Surgical Outcomes in Patients with Advanced High-Grade Serous Ovarian Cancer

Magdalena Postl et al. Cancers (Basel). .

Abstract

Background/objectives: The present study evaluates predictive implications of the pretherapeutic Fibrinogen-Albumin-Ratio Index (FARI) in high-grade serous ovarian cancer (HGSOC) patients undergoing primary cytoreductive surgery.

Methods: This retrospective study included 161 patients with HGSOC International Federation of Gynecology and Obstetrics (FIGO) stage ≥ IIb, who underwent primary cytoreductive surgery followed by platinum-based chemotherapy. Associations between the FARI and complete tumor resection status were described by receiver operating characteristics, and binary logistic regression models were fitted.

Results: Higher preoperative FARI values correlated with higher ascites volumes (r = 0.371, p < 0.001), and higher CA125 levels (r = 0.271, p = 0.001). A high FARI cut at its median (≥11.06) was associated with lower rates of complete tumor resection (OR 3.13, 95% CI [1.63-6.05], p = 0.001), and retrained its predictive value in a multivariable model independent of ascites volumes, CA125 levels, FIGO stage, and Charlson Comorbidity Index (CCI).

Conclusions: The FARI appears to act as a surrogate for higher intra-abdominal tumor load. After clinical validation, FARI could serve as a readily available serologic biomarker to complement preoperative patient assessment, helping to identify patients who are likely to achieve complete tumor resection during primary cytoreductive surgery.

Keywords: FARI; HGSOC; albumin; cytoreductive surgery; fibrinogen; neoadjuvant chemotherapy; ovarian cancer; tumor load.

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Conflict of interest statement

Nicole Concin: Payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing, or educational events: GSK, SEAGEN, Akesobio, AstraZeneca, eTheRNA, immunotherapies NV, Kartos, MSD, Mersana, ImmunoGen, EISAI, Seattle Genetics, TouchIME, Medscape Oncology; Support for attending meetings and/or travel: Roche, Genmab, Amgen; Participation on a data safety monitoring board or advisory board: GSK, Mersana, SEAGEN, ImmunoGen, Akesobio, EISAI, AstraZeneca, Mersana, Seattle Genetics, eTheRNA immunotherapies NV, Kartos; Leadership or fiduciary role in other board, society, committee, or advocacy groups, paid or unpaid: President—ESGO, Chair—ENGOT Early Drug Development Network, FIGO board member for women’s cancer. Stephan Polterauer: Payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing, or educational events: Astra Zeneca, GSK, MSD; Support for attending meetings and/or travel: Astra Zeneca; Leadership or fiduciary role in other board, society, committee, or advocacy groups, paid or unpaid: AGO Austria secretary. All other authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Consort diagram depicting all patients with ovarian cancer undergoing primary treatment who were not included into final analysis (n = 1013/1174, 86.3%). HGSOC, high-grade serous ovarian cancer; FIGO, International Federation of Gynaecology and Obstetrics.
Figure 2
Figure 2
(a) A high FARI ≥ 11.06 is associated with impaired progression-free survival in patients with advanced high-grade serous ovarian cancer. The yellow line depicts patients with a FARI < 11.06 and the blue line depicts patients with a FARI ≥ 11.06, with 95% confidence intervals, respectively. (b) A high FARI ≥ 11.06 is associated with impaired disease-specific survival in patients with advanced high-grade serous ovarian cancer. The yellow line depicts patients with a FARI < 11.06 and the blue line depicts patients with a FARI ≥ 11.06, with 95% confidence intervals, respectively.
See this image and copyright information in PMC

References

    1. du Bois A., Reuss A., Pujade-Lauraine E., Harter P., Ray-Coquard I., Pfisterer J. Role of Surgical Outcome as Prognostic Factor in Advanced Epithelial Ovarian Cancer: A Combined Exploratory Analysis of 3 Prospectively Randomized Phase 3 Multicenter Trials: By the Arbeitsgemeinschaft Gynaekologische Onkologie Studiengruppe Ovarialkarzinom (AGO-OVAR) and the Groupe d’Investigateurs Nationaux Pour Les Etudes Des Cancers de l’Ovaire (GINECO) Cancer. 2009;115:1234–1244. doi: 10.1002/cncr.24149. - DOI - PubMed
    1. Vergote I., Tropé C.G., Amant F., Kristensen G.B., Ehlen T., Johnson N., Verheijen R.H.M., van der Burg M.E.L., Lacave A.J., Panici P.B., et al. Neoadjuvant Chemotherapy or Primary Surgery in Stage IIIC or IV Ovarian Cancer. N. Engl. J. Med. 2010;363:943–953. doi: 10.1056/NEJMoa0908806. - DOI - PubMed
    1. Kehoe S., Hook J., Nankivell M., Jayson G.C., Kitchener H., Lopes T., Luesley D., Perren T., Bannoo S., Mascarenhas M., et al. Primary Chemotherapy versus Primary Surgery for Newly Diagnosed Advanced Ovarian Cancer (CHORUS): An Open-Label, Randomised, Controlled, Non-Inferiority Trial. Lancet. 2015;386:249–257. doi: 10.1016/S0140-6736(14)62223-6. - DOI - PubMed
    1. Fagotti A., Ferrandina M.G., Vizzielli G., Pasciuto T., Fanfani F., Gallotta V., Margariti P.A., Chiantera V., Costantini B., Gueli Alletti S., et al. Randomized Trial of Primary Debulking Surgery versus Neoadjuvant Chemotherapy for Advanced Epithelial Ovarian Cancer (SCORPION-NCT01461850) Int. J. Gynecol. Cancer. 2020;30:1657–1664. doi: 10.1136/ijgc-2020-001640. - DOI - PubMed
    1. Onda T., Satoh T., Ogawa G., Saito T., Kasamatsu T., Nakanishi T., Mizutani T., Takehara K., Okamoto A., Ushijima K., et al. Comparison of Survival between Primary Debulking Surgery and Neoadjuvant Chemotherapy for Stage III/IV Ovarian, Tubal and Peritoneal Cancers in Phase III Randomised Trial. Eur. J. Cancer. 2020;130:114–125. doi: 10.1016/j.ejca.2020.02.020. - DOI - PubMed

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