Chinese researchers have developed a promising new predictive tool for epithelial ovarian cancer outcomes, utilizing a pan-immune-inflammation (PIV)-based nomogram that effectively forecasts both overall survival (OS) and progression-free survival (PFS) in patients.
The study, published in BMC Cancer, addresses a critical need in ovarian cancer management, where the 5-year survival rate remains below 50% despite advanced treatment options. The research focused on creating a more accurate prediction model specifically for Chinese patients, moving beyond the limitations of existing models based on SEER database information.
Significant Survival Differences Based on PIV Scores
The research team analyzed 576 patients treated at Xijing Hospital between January 2010 and December 2019, dividing them into high PIV (>254.9) and low PIV (≤254.9) groups. The results revealed striking differences in survival outcomes:
- 3-year survival rates: 76.71% for low PIV vs 61.34% for high PIV
- 5-year survival rates: 51.14% for low PIV vs 25.21% for high PIV
- 3-year PFS rates: 65.30% for low PIV vs 40.90% for high PIV
- 5-year PFS rates: 39.73% for low PIV vs 19.33% for high PIV
Comprehensive Prognostic Model Development
The researchers identified key prognostic factors through Cox analysis, incorporating six variables for OS prediction:
- Positive lymph nodes
- Histological type
- Pre-treatment CA125 levels
- Ascites presence
- PIV score
- FIGO stage
For PFS prediction, five independent indicators were established: FIGO stage, pre-treatment CA125 value, PIV, histological stage, and surgical modality.
Model Validation and Performance
The nomogram demonstrated robust predictive capabilities across both training (n=405) and validation (n=171) cohorts. For overall survival prediction, the model achieved impressive area under the curve (AUC) values:
Training Cohort:
- 3-year OS: 0.713
- 5-year OS: 0.796
- 10-year OS: 0.839
Validation Cohort:
- 3-year OS: 0.676
- 5-year OS: 0.803
- 10-year OS: 0.685
Clinical Implications and Future Directions
During the study period, 224 patients (38.9%) experienced disease relapse, and 249 (43.2%) died, with a median PFS of 36.7 months and a 3-year cumulative OS rate of 67.4%. These outcomes underscore the importance of accurate prognostic tools in clinical decision-making.
While the study shows promising results, the researchers acknowledge certain limitations, including the single-center nature of the data and potential selection bias. They are actively seeking collaboration with other centers to validate their findings further and expand the model's applicability.
The development of this PIV-based nomogram represents a significant step forward in personalized prognostic assessment for epithelial ovarian cancer patients, potentially enabling more tailored treatment approaches and improved patient counseling.
