Impact of the completeness of cytoreductive surgery on the prognostic role of the KELIM score in patients treated for ovarian peritoneal metastasis.

INTRODUCTION

The two major treatment related prognostic factors for peritoneal metastasis of ovarian cancer (PMOC) are chemosensitivity and completeness of cytoreduction (CC). Chemosensitivity can be assessed by the CA-125 elimination rate constant K (KELIM) score, based on CA-125 kinetics. CC is evaluated by residual macroscopic disease. The aim of this study was to evaluate the prognostic impact of KELIM score versus CC, in a population who underwent complete (CC-0) and near-complete (CC-1) debulking.

MATERIALS AND METHODS

Monocentric retrospective study including patients with primary PMOC treated with curative intent between January 2010 and December 2021. The Biomarker Kinetics website (CA-125 KELIM Calculator) was used to calculate the KELIM score. Univariate and multivariate analysis were performed to assess the impact of CC and KELIM score on PFS and OS.

RESULTS

A total of 111 patients were included in the study. Kaplan-Meier analysis showed that PFS and OS were significantly influenced by KELIM, CC, PCI, and BRCA mutation (p < 0.05). Multivariate Cox analysis showed that PFS was significantly influenced by CC (HR = 0.481, p = 0.0027), while OS was influenced by KELIM (HR 0.561, p = 0.0408).

CONCLUSION

These results suggest that PFS is more impacted by the completeness of the surgery than the KELIM score and the KELIM score influences OS more than the completeness of surgery.