Background and Objectives: Serum albumin is a widely available and inexpensive biomarker that reflects nutritional status and physiological reserve. Hypoalbuminemia has been linked to poor postoperative outcomes in surgical oncology; however, its role in predicting early complications after cytoreductive surgery for ovarian cancer, as well as the potential contribution of systemic inflammatory indices in nutritionally preserved patients, remains incompletely understood. This study aimed to evaluate the predictive value of early postoperative serum albumin for early surgical complications and to explore whether inflammatory indices could offer additional prognostic information in patients with adequate albumin levels. Materials and Methods: We conducted a retrospective observational cohort study including patients undergoing cytoreductive surgery for ovarian cancer at two Italian tertiary referral centers between July 2023 and December 2025. Postoperative serum albumin was measured on the first postoperative day. Systemic inflammatory parameters were assessed using perioperative changes in neutrophils and composite indices. Early postoperative complications occurring within 30 days were recorded. Multivariable logistic regression analyses were performed, and subgroup analyses were conducted in patients with postoperative albumin ≥3 g/dL. Receiver operating characteristic (ROC) analysis was used to identify an optimal cutoff for significant inflammatory predictors. Results: A total of 121 patients were included, of whom 30 developed early postoperative complications. Patients with complications had significantly lower postoperative albumin levels than those without complications (median 2.75 vs. 3.09 g/dL; p < 0.001). In multivariable analysis, lower postoperative albumin independently predicted early complications (OR 0.26, 95% CI 0.06–0.86). In the subgroup of patients with preserved albumin levels (≥3 g/dL), a smaller postoperative neutrophil decline independently predicted complications (OR 1.56, 95% CI 1.12–2.70). A neutrophil drop cutoff of −1.15 × 10³/dL showed good specificity (81.5%) and high negative predictive value (95.7%). Conclusions: Early postoperative serum albumin is a strong predictor of early surgical complications after cytoreductive surgery for ovarian cancer. In patients with preserved nutritional status, dynamic neutrophil changes provide additional prognostic information. Incorporating low-cost metabolic and inflammatory biomarkers may enhance early postoperative risk stratification and support more personalized patient management.

Background and Objectives: Systemic inflammatory indices derived from routine blood tests have been proposed as potential biomarkers reflecting tumor behavior. This study aimed to evaluate their association with parameters of locoregional tumor progression in cervical cancer. Materials and Methods: This prospective observational study (CERTIFIKO) included 79 patients with cervical cancer enrolled between July 2023 and December 2025. This study was registered on ClinicalTrials.gov (NCT05673252). Pre-treatment blood samples were used to calculate the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic inflammatory response (SIR), and systemic inflammatory response index (SIRI). Tumor progression parameters included stromal infiltration, parametrial involvement, lymphovascular space invasion (LVSI), fornix involvement, lymph node status, histotype, and grading. Associations were assessed using non-parametric tests and linear regression models. Results: Stromal infiltration was significantly associated with PLR (p = 0.011), MLR (p = 0.010), and NLR (p = 0.010). Parametrial involvement was associated with MLR (p = 0.004) and NLR (p = 0.012). Diffuse LVSI was associated with PLR (p = 0.002), NLR (p = 0.006), SIR (p = 0.008), and SIRI (p = 0.034). In multivariable linear regression models, diffuse LVSI remained associated with higher PLR and NLR values, whereas parametrial involvement remained associated with higher MLR, NLR, and SIRI. No significant associations were observed for fornix involvement, histotype, or lymph node status. Conclusions: Systemic inflammatory indices were associated with parameters of locoregional tumor progression in this exploratory cohort of patients with cervical cancer. These findings warrant further evaluation in larger studies before any potential clinical application.