Ravi Ramya D, Kulkarni Kiran A, Acharya Geeta, Siddharta Premalatha, Ravikumar Gayatri, Bidkar Vishakha C, Mohanapriya D
Department of Gynecologic Oncology, St John's Medical College, Bengaluru, Karnataka, India.
Department of Pathology, St John's Medical College, Bengaluru, Karnataka, India.
Indian J Cancer. 2025 Jan 1;62(1):17-22. doi: 10.4103/ijc.ijc_894_21. Epub 2025 May 16.
To assess the role of omental and ovarian chemotherapy response score (CRS) and CA125 as a predictor of prognosis in patients with tubo-ovarian high-grade serous carcinoma (HGSC)/primary peritoneal carcinoma (PPC) receiving neoadjuvant chemotherapy (NACT). In addition, to study the correlation of omental CRS with chemoresistance.
A retrospective record review of patients with tubo-ovarian HGSC/PPC receiving NACT followed by interval debulking surgery (IDS) between January 2012 and May 2020 was done. The slides of the omentum and ovarian tissue of the patients were retrieved and reviewed by a trained pathologist. During analysis, CRS 1 and CRS 2 were merged together for comparison against CRS 3.
A total of 44 patients with a mean age of 54 years were included in the study. Among the patients, 29.5%, 38.6%, and 31.8% had a CRS of 1, 2, and 3, respectively, on the omental specimen and 31.8%, 43.2%, and 25% on the ovarian specimen. Median PFS and OS was significantly better with omental CRS 3 (P = < 0.0001 and P = < 0.00065). No significant difference in median OS of patients was noted with ovarian CRS 1, 2, or 3 (P = 0.057); however, the median PFS was significantly better in patients with CRS 3 on ovarian tissue (P = 0.036). Platinum resistance was significantly lower in patients with CRS 3 on omentum (P = 0.001). The value of CA125 post NACT had a significant association with PFS on both univariate and multivariate analyses. There was no statistically significant correlation between CA125 and omental CRS.
Omental CRS has a prognostic significance for patients with tubo-ovarian HGSC/PPC receiving NACT and correlates significantly with PFS and OS. Ovarian CRS correlates significantly only with PFS. Post NACT CA125 value had a significant association with PFS.
评估网膜和卵巢化疗反应评分（CRS）及CA125作为接受新辅助化疗（NACT）的输卵管卵巢高级别浆液性癌（HGSC）/原发性腹膜癌（PPC）患者预后预测指标的作用。此外，研究网膜CRS与化疗耐药性的相关性。
对2012年1月至2020年5月期间接受NACT后行间隔减瘤手术（IDS）的输卵管卵巢HGSC/PPC患者进行回顾性记录审查。收集患者的网膜和卵巢组织切片，由一名经过培训的病理学家进行复查。分析过程中，将CRS 1和CRS 2合并在一起与CRS 3进行比较。
本研究共纳入44例平均年龄为54岁的患者。在这些患者中，网膜标本的CRS为1、2和3的分别占29.5%、38.6%和31.8%，卵巢标本的分别占31.8%、43.2%和25%。网膜CRS为3时，中位无进展生存期（PFS）和总生存期（OS）显著更好（P = < 0.0001和P = < 0.00065）。卵巢CRS为1、2或3的患者，中位OS无显著差异（P = 0.057）；然而，卵巢组织CRS为3的患者中位PFS显著更好（P = 0.036）。网膜CRS为3的患者铂耐药率显著更低（P = 0.001）。NACT后CA125的值在单因素和多因素分析中均与PFS有显著关联。CA125与网膜CRS之间无统计学显著相关性。
网膜CRS对接受NACT的输卵管卵巢HGSC/PPC患者具有预后意义，且与PFS和OS显著相关。卵巢CRS仅与PFS显著相关。NACT后CA125值与PFS有显著关联。
