Validation of the KELIM score as a predictor of response to neoadjuvant treatment in patients with advanced high grade serous ovarian cancer.

Humans Female Ovarian Neoplasms / drug therapy Neoadjuvant Therapy Retrospective Studies Cytoreduction Surgical Procedures
CA-125 KELIM score Neoadjuvant chemotherapy Ovarian cancer Survival

Journal

Gynecologic oncology
ISSN: 1095-6859
Titre abrégé: Gynecol Oncol
Pays: United States
ID NLM: 0365304

Informations de publication

Date de publication:
12 2022
Historique:
received: 12 07 2022
revised: 17 10 2022
accepted: 18 10 2022
medline: 18 5 2023
pubmed: 16 5 2023
entrez: 16 5 2023
Statut: ppublish

Résumé

The objective of this study is to externally validate the KELIM (rate of elimination of CA-125 elimation) score in patients with high grade serous ovarian cancer(HGSC)undergoing NACT and determine its relation to outcome of cytoreduction, platinum sensitivity, progression free(PFS) and overall survival(OS). This is a retrospective cohort study of patients with Stage III-IV HGSC diagnosed between January 1, 2010 and December 31, 2019 and treated with NACT. KELIM score was calculated using at least 3 CA-125 values within the first 100 days of chemotherapy. Demographic parameters were collected and Kaplan Meier survival analyses were performed for PFS and OS. This study was approved by local ethics board. 217 patients met inclusion criteria. Median follow-up was 28.93 months(range 2.86-135.06). There was no significant difference in stage, functional status, cytoreductive outcome or BRCA status(germline or somatic) between patients with a KELIM ≥ 1 and <1. Patients with a KELIM<1 had a lower median PFS (13.58 vs 19.69, p < 0.001), median platinum free interval(PFI) (7.66 vs 13.64, p < 0.001) and 5-year OS (57% vs 72%, p = 0.0140) compared to patients with KELIM≥1 . After adjusting for stage, treatment delays, bevacizumab or poly adenosine diphosphate-ribose polymerase(parp)-inhibitor use, and BRCA status, patients with KELIM<1 had a high risk of disease progression(HR = 1.57 (95% CI 1.08-2.28) and death(HR = 1.99 (95% CI 1.01-3.95) compared to KELIM≥1. BRCA status was independently associated to an increase on KELIM score (OR = 1.917, 95% CI 1.046-3.512, p = 0.035). Patients with advanced HGSC undergoing NACT with a KELIM <1 were more likely to have platinum-resistant disease, worse PFS and worse OS when compared to patients with KELIM≥1. The KELIM score can be a helpful tool to predict chemo-response and aid in treatment decision making.

Identifiants

DOI: 10.1016/j.ygyno.2022.10.014 PMID: 37191644
pubmed: 37191644
pii: S0090-8258(22)01891-1
doi: 10.1016/j.ygyno.2022.10.014
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

417-422

Informations de copyright

Copyright © 2022 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest There are no relevant conflicts of interests to disclose.

Auteurs

Sabrina Piedimonte (S)

Division of Gynecologic Oncology, University of Toronto, Toronto, Ontario, Canada.

Rachel Kim (R)

Division of Gynecologic Oncology, University of Toronto, Toronto, Ontario, Canada.

Marcus Q Bernardini (MQ)

Division of Gynecologic Oncology, University of Toronto, Toronto, Ontario, Canada; Division of Gynecologic Oncology, Department of Surgical Oncology, Princess Margaret Cancer Center, Toronto, Ontario, Canada.

Eshetu G Atenafu (EG)

Division of Biostatistics and Epidemiology, University Health Network, Toronto, Ontario, Canada.

Mitchell Clark (M)

Smilow Cancer Center, Yale University, CT, USA.

Stephanie Lheureux (S)

Division of Medical Oncology, Princess Margaret Cancer Center, Toronto, Ontario, Canada.

Taymaa May (T)

Division of Gynecologic Oncology, University of Toronto, Toronto, Ontario, Canada; Division of Gynecologic Oncology, Department of Surgical Oncology, Princess Margaret Cancer Center, Toronto, Ontario, Canada. Electronic address: Taymaa.May@uhn.ca.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Validation of the KELIM score as a predictor...
questionsmedicales.fr › Maladies endocriniennes › Troubles gonadiques › Maladies ovariennes › Tumeurs de l'ovaire › Validation of the KELIM score as a predictor...
questionsmedicales.fr › Thérapeutique › Association thérapeutique › Traitement néoadjuvant › Validation of the KELIM score as a predictor...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Validation of the KELIM score as a predictor...
questionsmedicales.fr › Procédures de chirurgie opératoire › Interventions chirurgicales de cytoréduction › Validation of the KELIM score as a predictor...