Ovarian cancer (OC) is the most lethal gynecologic cancer; it is responsible for approximately 14070 deaths and 22240 new cases in the United States annually.
Primary debulking surgery (PDS) followed by a combination of platinum-paclitaxel based chemotherapy is currently considered as the standard of care for advanced epithelial ovarian cancer (AEOC). In patients with wide and aggressive tumour dissemination an alternative treatment strategy is neoadjuvant chemotherapy (NACT) with delayed surgery (i.e., interval debulking surgery, IDS). There are no sensitive and specific screening methods for epithelial ovarian cancer diagnosis.
Inflammation in the tumor microenvironment plays an important role in the proliferation and survival of malignant cells. Numerous studies evaluated preoperative inflammatory markers, such as neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), proving that they may reach significant levels in the blood, predicting the presence of EOC. Furthermore there are few study that prove the role of these inflammatory markers as useful screening tests for EOC.
The aim of our retrospective study is to evaluate the mean value of preoperative NLR in order to possibly differentiate between ovarian cancer and benign adnexal masses.
Ovarian cancer is considered a chronic disease and it has a very poor prognosis. Early diagnosis can improve survival. Ca125 is a marker with high sensitivity but low specificity. Moreover Ca125 is tested when a suspect of ovarian mass is already present. NLR is a new marker of cancer and can be easily diagnosed with a routinely blood sample.
NLR meets the criteria of a screening test, like safety, accessibility and economy. NLR to Ca125 could improve the capacity to discriminate between malign and benign, and could also be tested in the future as a marker for screening for ovarian disease.