Inflammatory Markers may Determine Postoperative Complications in Cases of Peritoneal Carcinomatosis of Ovarian Origin Treated With Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

BACKGROUND AND OBJECTIVES: This study aimed to evaluate the ability of perioperative inflammatory markers to discriminate postoperative complications within 6 months in patients with ovarian cancer-related peritoneal metastasis undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). MATERIALS AND METHODS: This retrospective cohort study included patients with ovarian cancer-related peritoneal metastasis who underwent CRS and HIPEC between January 2011 and August 2022. Data were obtained from the Hospital Information Management System, patient medical records, and anesthesia charts. Systemic immune-inflammation index (SII), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) were assessed preoperatively (within 7 days before surgery) and on postoperative days 1, 3, and 5. Postoperative complications occurring within 6 months were graded according to the Clavien-Dindo classification; major complications were defined as Clavien-Dindo grade ≥III. Receiver operating characteristic (ROC) curve analysis was used to evaluate the discriminatory performance of inflammatory markers. RESULTS: In the preoperative period, AUCs were 0.655 (95% CI: 0.568-0.742) for NLR, 0.655 (95% CI: 0.568-0.742) for PLR, and 0.689 (95% CI: 0.607-0.772) for SII. On POD3, AUCs were 0.638 (0.551-0.726), 0.619 (0.531-0.707), and 0.673 (0.589-0.758), respectively. On POD5, AUCs were 0.724 (0.645-0.803), 0.695 (0.612-0.779), and 0.740 (0.663-0.818), respectively. CONCLUSIONS: Perioperative NLR, PLR, and SII showed measurable discrimination for 6-month postoperative complications, with numerically higher AUCs on POD5.