Serum Albumin Predicts Chemotherapy Response In Advanced Epithelial Ovarian Cancer: A Cohort Study

Abstract

Background and aim: Most ovarian cancer cases are diagnosed at an advanced stage, where predicting chemotherapy response is critical but currently depends on operative assessments and complex biomarkers. This study evaluated whether pre-chemotherapy easily accessible blood-based biomarkers such as D-dimer, albumin, and systemic inflammatory indices (NLR, PLR, MLR) could provide a practical way to estimate chemotherapy response.

Methods: This cohort study, conducted at Dr. Wahidin Sudirohusodo Hospital, Indonesia, included 46 women with advanced epithelial ovarian cancer. Pre-chemotherapy levels of D-dimer, albumin, and inflammatory markers (NLR, PLR, MLR) were measured. Chemotherapy response was assessed using RECIST criteria, and predictive value was analysed.

Results: Among the 46 patients, higher pre-chemotherapy serum albumin levels were significantly associated with a better treatment response (p = 0.001). Logistic regression showed that each unit increase in albumin was associated with over ninefold higher odds of response (OR = 9.11; 95% CI: 2.35–35.25). The predictive model based on albumin demonstrated good diagnostic performance, with sensitivity of 73.3%, specificity of 75%, positive predictive value of 84.6%, and negative predictive value of 60%. In contrast, pre-chemotherapy levels of D-dimer and inflammatory markers (NLR, PLR, MLR) were not significantly associated with chemotherapy response in this cohort

Conclusions: Serum albumin measured before chemotherapy found to be a significant predictor of treatment response, providing a simple and reliable tool to help guide treatment planning in women with advanced epithelial ovarian cancer