Prognostic Impact of Serum microRNA Profiles on the Progression-Free Survival of Patients With High-Grade Serous Ovarian Cancer Receiving Neoadjuvant Chemotherapy.

AIM: High-grade serous ovarian cancer is a deadly cancer with a poor prognosis. Serum microRNAs have been used to detect and diagnose various cancers. We aimed to investigate the prognostic impact of serum microRNA profiles pre-, peri-, and post-primary treatment on the progression-free survival of patients with advanced high-grade serous ovarian cancer receiving neoadjuvant chemotherapy. METHODS: Patients were prospectively recruited, and pre-, peri-, and post-treatment blood samples were collected. MicroRNA microarray results, together with the clinical and surgical data, were analyzed using Cox regression with leave-one-out least absolute shrinkage and selection operator for progression-free survival. RESULTS: Overall, 29 patients were included. A combined analysis of pre-treatment serum microRNAs and clinical factors showed a higher c-index (0.86) for distinguishing high- and low-risk groups for poor progression-free survival outcomes compared to analyzing each factor alone (0.70 and 0.64, respectively). The high-risk group exhibited significantly worse progression-free survival (log-rank, p < 0.01). The serum microRNA profile at 3 months post-treatment showed outstanding discrimination (c-index of 1.00). Changes in the microRNA profile between pre- and peri-treatment had no prognostic impact; however, the difference between pre-treatment and 3 months post-treatment exhibited excellent discrimination (c-index of 1.00). CONCLUSIONS: In patients with advanced high-grade serous ovarian cancer who received neoadjuvant chemotherapy, a combination of the pre-treatment serum microRNA profiles and clinical factors, or the 3-month post-treatment serum microRNA profile could distinguish between those in high- and low-risk groups for poor progression-free survival outcomes.