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Predictive and Prognostic Factors in Epithelial Ovarian Cancer: A Review

A. Giró,T. Herrmann,Arthur Bauer,Céleste Pinard,Mélanie Godiveau,J. Passildas,C. Abrial,X. Durando

Published 2025 in Indian Journal of Gynecologic Oncology

ABSTRACT

Ovarian cancer is the eighth most common cancer among women, accounting for 4.7% of all cancer-related deaths. In this review, we aimed to describe both established and emerging, prognostic and predictive factors. Some established prognostic factors are clinical, such as age, ECOG, and Body Mass Index. Histological subtype, stage and grade are also prognostic factors, and optimal surgery is one of the main factors. Furthermore, the presence of ascites at diagnosis and cancer Antigen 125 assessment could help to predict patient outcomes. Nevertheless, median survival is less than 5 years. Among the emerging factors, tumor-infiltrating lymphocytes (TILs) have a proven prognostic value, although their predictive value has not been used in routine practice. Inflammatory response marker ratios, i.e., neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios, could have a prognostic value. Circulating tumor DNA is one of the most promising prognostic and predictive factors. Concerning predictive factors, the main one is homologous recombination deficiency, which is a marker for response to PARP inhibitors and platin-based chemotherapy. The KELIM score is also used to predict chemosensitivity. To be validated in routine practice, other predictive factors require further investigation. Despite the poor prognosis in this pathology, some patients are still alive 10 years after diagnosis. A better understanding of this population’s characteristics could help to anticipate patient outcomes and thus adapt their management.

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