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CA-125清除率常数K(KELIM)对上皮性卵巢癌无进展生存期和总生存期的预测价值

Predictive Value of the CA-125 Elimination Rate Constant K (KELIM) in Predicting Progression-Free Survival and Overall Survival in Epithelial Ovarian Cancer.

作者信息

Yalcin Necim, Alci Aysun, Gokkaya Mustafa, Sari Gulsum Ekin, Toptas Tayfun, Ureyen Isin

机构信息

Department of Gynecologic Oncology, Antalya Training and Research Hospital, Saglik Bilimleri University, 07100 Antalya, Turkey.

出版信息

Medicina (Kaunas). 2025 Jul 10;61(7):1250. doi: 10.3390/medicina61071250.

Abstract

It is crucial to predict the response to chemotherapy and identify prognostic markers for recurrence and survival in patients with epithelial ovarian cancer (EOC), in order to effectively manage patient care. The CA-125 elimination rate constant K (KELIM) has recently been developed as a means of assessing the chemotherapy response and has been tested mainly in patients enrolled in randomized controlled trials. The objective of this study was to investigate whether the KELIM score is a prognostic marker for progression-free survival (PFS) and overall survival (OS) in EOC, utilizing its role in predicting the chemotherapy response in real-life settings. Demographic, surgical, and survival data of patients with EOC operated on in Antalya Training and Research Hospital between January 2015 and December 2021 were obtained from the electronic gynecological oncology clinic database system and analyzed retrospectively. A total of 102 patients with EOC were included; 30 patients (29.4%) had a KELIM score ≥ 1 and 72 (70.6%) patients had a KELIM score < 1. In the group with a KELIM score < 1, recurrence and refractory disease occurred in 49 patients, while it was 11 patients in the group with a KELIM score ≥ 1 ( = 0.004). PFS was 12 months and 32 months in the groups with KELIM scores of <1 and ≥1, respectively ( = 0.012). There was no difference between groups regarding OS ( = 0.139). In the whole group, KELIM score (<1 vs. ≥1) and type of surgery (IDS vs. PDS) were found to be independent prognostic factors for PFS (RR = 0.44; 95%CI: 0.22-0.88; = 0.021 and RR = 2.97; 95%CI: 1.76-5.01; < 0.001, respectively). We found that a favorable KELIM score was associated with better PFS in all groups of patients undergoing surgery for EOC in a real-life setting. With the increasing number of studies, the KELIM score will play an important role in providing better guidance to clinicians at the initial presentation of patients and in subsequent treatment planning.

摘要

预测上皮性卵巢癌(EOC)患者对化疗的反应并确定复发和生存的预后标志物,对于有效管理患者护理至关重要。CA - 125消除率常数K(KELIM)最近已被开发出来作为评估化疗反应的一种方法,并且主要在参加随机对照试验的患者中进行了测试。本研究的目的是利用KELIM评分在预测现实生活中化疗反应的作用,探讨其是否为EOC患者无进展生存期(PFS)和总生存期(OS)的预后标志物。从电子妇科肿瘤门诊数据库系统中获取2015年1月至2021年12月在安塔利亚培训与研究医院接受手术的EOC患者的人口统计学、手术和生存数据,并进行回顾性分析。共纳入102例EOC患者;30例(29.4%)患者KELIM评分≥1,72例(70.6%)患者KELIM评分<1。在KELIM评分<1的组中,49例患者出现复发和难治性疾病,而在KELIM评分≥1的组中为11例(P = 0.004)。KELIM评分<1和≥1的组中PFS分别为12个月和32个月(P = 0.012)。两组在OS方面无差异(P = 0.139)。在整个组中,发现KELIM评分(<1 vs.≥1)和手术类型(IDS vs. PDS)是PFS的独立预后因素(RR = 0.44;95%CI:0.22 - 0.88;P = 0.021和RR = 2.97;95%CI:1.76 - 5.01;P < 0.001,分别)。我们发现,在现实生活中接受EOC手术的所有患者组中,良好的KELIM评分与更好的PFS相关。随着研究数量的增加,KELIM评分将在患者初次就诊时为临床医生提供更好的指导以及在后续治疗规划中发挥重要作用。

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