Is the preoperative routine blood test workable to distinguish early-stage from advanced-stage ovarian cancer?

OBJECTIVE: Preoperative routine blood test, such as complete blood counts (CBC) and nutrition markers may be associated with outcome of patients with epithelial ovarian cancer (OC); however, the value of the aforementioned test associated with the stage of OC is uncertain. This study aimed to determine the association between ten routine laboratory-based indices and the early-stage or advanced-stage OC (easOC or adsOC), particularly in low-resource country. MATERIALS AND METHODS: This retrospective cross-sectional analysis enrolled 98 patients with histologically confirmed OC who were treated between 2022 and 2023. The 10 preoperative indices calculated from CBC and nutrition markers included platelet-to-lymphocyte ratio (PLR), prognostic nutritional index (PNI), hemoglobin-albumin-lymphocyte-platelet score (HALPS), lymphocyte-to-monocyte ratio (LMR), monocyte-to-albumin ratio (MAR), platelet-to-albumin ratio (PAR), monocyte-to-lymphocyte ratio (MLR), white blood cell-to-hemoglobin ratio (WHR), monocyte-to-hemoglobin ratio (MHR), and hemoglobin-to-lymphocyte ratio (HLR). Group differences and discriminatory ability for easOC (International Federation of Gynecology and Obstetrics [FIGO] I-II) versus adsOC (FIGO III-IV) disease were assessed using nonparametric tests and receiver operating characteristic (ROC) analyses. RESULTS: Most indices showed no significant variation across the FIGO stages. Patients with adsOC had significantly lower PNI (p = 0.013), whereas their MAR showed a borderline increase (p = 0.054). ROC analysis demonstrated modest performance; PNI achieved the highest area under the curve (AUC, 0.648; p = 0.009; specificity, 75.4%), and MAR showed an AUC of 0.615 (p = 0.048; sensitivity, 78%). All the other indices demonstrated limited discriminatory values (AUC, 0.51-0.60). CONCLUSION: The value of the preoperative routine blood test, such as CBC and nutrition markers for distinguishing easOC from adsOC may be limited, although PNI and MAR showed the positive association. A large cohort study may be needed to clarify the association between preoperative routine blood test and staging OC.