H D Liu, H L Wu, L L Ma, Y Cui, S W Wang, G H Shen
{"title":"[CA125清除率常数K评分在高级别浆液性卵巢癌间歇减容手术患者预后预测中的应用]。","authors":"H D Liu, H L Wu, L L Ma, Y Cui, S W Wang, G H Shen","doi":"10.3760/cma.j.cn112141-20250102-00001","DOIUrl":null,"url":null,"abstract":"<p><p><b>Objective:</b> To investigate the predictive value of the cancer antigen 125 (CA<sub>125</sub>) elimination rate constant K (KELIM) score for no visible residual disease (R0) and prognosis in high-grade serous ovarian carcinoma (HGSOC) patients undergoing neoadjuvant chemotherapy (NACT)+interval debulking surgery (IDS). <b>Methods:</b> A retrospective analysis was conducted on 78 HGSOC patients treated with NACT+IDS at Beijing Hospital, from June 2014 to June 2024. The KELIM score was calculated, and its predictive value for R0 resection, chemotherapy response score (CRS), platinum-free interval (PFI), progression-free survival (PFS) time, and overall survival (OS) time was analyzed. <b>Results:</b> (1) The mean age at diagnosis was (61.9±9.9) years. The mean KELIM score was 1.1±0.4, with 44 patients having KELIM score≥1 and 34 having KELIM score <1. (2) Patients with KELIM score ≥1 had significantly higher rates of R0 resection (84% vs 56%; <i>P</i>=0.006), CRS3 grading (41% vs 0; <i>P</i><0.001), and PFI ≥6 months (84% vs 53%; <i>P</i>=0.04) compared to those with KELIM score <1. Additionally, the median PFS time (18.7 vs 13.2 months; <i>P</i><0.001) and OS time (34.8 vs 29.9 months; <i>P</i>=0.007) were significantly longer in the KELIM score ≥1 group. Chemosensitivity: patients with PFI <6 months had a significantly lower median KELIM score than those with PFI ≥6 months (0.8 vs 1.2; <i>P</i>=0.005). Surgical outcome: patients achieving R0 resection had a significantly higher median KELIM score than those without R0 (1.2 vs 0.7; <i>P</i><0.001). (3) Univariate analysis identified non-R0 resection, CRS3 grading, lack of poly adenosine diphosphate ribose polymerase (PARP) inhibitor maintenance therapy, and KELIM score <1 as significant risk factors for OS time (all <i>P</i><0.05). Multivariate analysis confirmed non-R0 resection (<i>HR</i>=3.78,95%<i>CI</i>: 1.13-12.66; <i>P</i>=0.031), no PARP inhibitor maintenance (<i>HR</i>=7.41,95%<i>CI</i>:1.82-30.15; <i>P</i>=0.005), and KELIM score <1 (<i>HR</i>=5.14,95%<i>CI</i>:1.41-18.72; <i>P</i>=0.013) as independent risk factors for OS time. <b>Conclusions:</b> The KELIM score may serve as a predictive marker for chemosensitivity, R0 resection, PFS time, and OS time in HGSOC patients undergoing NACT+IDS. KELIM score<1 is an independent risk factor for OS.</p>","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 6","pages":"461-468"},"PeriodicalIF":0.0000,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[Application of CA<sub>125</sub> elimination rate constant K score in prognostic forecast of patients undergoing interval debulking surgery for high grade serous ovarian cancer].\",\"authors\":\"H D Liu, H L Wu, L L Ma, Y Cui, S W Wang, G H Shen\",\"doi\":\"10.3760/cma.j.cn112141-20250102-00001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Objective:</b> To investigate the predictive value of the cancer antigen 125 (CA<sub>125</sub>) elimination rate constant K (KELIM) score for no visible residual disease (R0) and prognosis in high-grade serous ovarian carcinoma (HGSOC) patients undergoing neoadjuvant chemotherapy (NACT)+interval debulking surgery (IDS). <b>Methods:</b> A retrospective analysis was conducted on 78 HGSOC patients treated with NACT+IDS at Beijing Hospital, from June 2014 to June 2024. The KELIM score was calculated, and its predictive value for R0 resection, chemotherapy response score (CRS), platinum-free interval (PFI), progression-free survival (PFS) time, and overall survival (OS) time was analyzed. <b>Results:</b> (1) The mean age at diagnosis was (61.9±9.9) years. The mean KELIM score was 1.1±0.4, with 44 patients having KELIM score≥1 and 34 having KELIM score <1. (2) Patients with KELIM score ≥1 had significantly higher rates of R0 resection (84% vs 56%; <i>P</i>=0.006), CRS3 grading (41% vs 0; <i>P</i><0.001), and PFI ≥6 months (84% vs 53%; <i>P</i>=0.04) compared to those with KELIM score <1. Additionally, the median PFS time (18.7 vs 13.2 months; <i>P</i><0.001) and OS time (34.8 vs 29.9 months; <i>P</i>=0.007) were significantly longer in the KELIM score ≥1 group. Chemosensitivity: patients with PFI <6 months had a significantly lower median KELIM score than those with PFI ≥6 months (0.8 vs 1.2; <i>P</i>=0.005). Surgical outcome: patients achieving R0 resection had a significantly higher median KELIM score than those without R0 (1.2 vs 0.7; <i>P</i><0.001). (3) Univariate analysis identified non-R0 resection, CRS3 grading, lack of poly adenosine diphosphate ribose polymerase (PARP) inhibitor maintenance therapy, and KELIM score <1 as significant risk factors for OS time (all <i>P</i><0.05). Multivariate analysis confirmed non-R0 resection (<i>HR</i>=3.78,95%<i>CI</i>: 1.13-12.66; <i>P</i>=0.031), no PARP inhibitor maintenance (<i>HR</i>=7.41,95%<i>CI</i>:1.82-30.15; <i>P</i>=0.005), and KELIM score <1 (<i>HR</i>=5.14,95%<i>CI</i>:1.41-18.72; <i>P</i>=0.013) as independent risk factors for OS time. <b>Conclusions:</b> The KELIM score may serve as a predictive marker for chemosensitivity, R0 resection, PFS time, and OS time in HGSOC patients undergoing NACT+IDS. KELIM score<1 is an independent risk factor for OS.</p>\",\"PeriodicalId\":10050,\"journal\":{\"name\":\"中华妇产科杂志\",\"volume\":\"60 6\",\"pages\":\"461-468\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-06-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"中华妇产科杂志\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3760/cma.j.cn112141-20250102-00001\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"中华妇产科杂志","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3760/cma.j.cn112141-20250102-00001","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
目的：探讨癌抗原125 （CA125）消除速率常数K （KELIM）评分对高级别浆液性卵巢癌（HGSOC）患者新辅助化疗(NACT)+间期减容手术（IDS）无可见残留病（R0）及预后的预测价值。方法：回顾性分析2014年6月至2024年6月北京医院接受NACT+IDS治疗的78例HGSOC患者。计算KELIM评分，并分析其对R0切除、化疗反应评分（CRS）、无铂期（PFI）、无进展生存期（PFS）时间、总生存期（OS）时间的预测价值。结果：(1)平均诊断年龄为（61.9±9.9）岁。平均KELIM评分为1.1±0.4，其中KELIM评分≥1者44例，KELIM评分P=0.006者34例)，CRS3分级(41% vs 0；（PP=0.04）与KELIM评分≥1组（PP=0.007）相比，病程明显延长。化疗敏感性：PFI患者P=0.005)。手术结果：完成R0切除的患者的中位KELIM评分显著高于未完成R0切除的患者(1.2 vs 0.7；PPHR = 3.78, 95% ci: 1.13—-12.66;P=0.031)，无PARP抑制剂维持(HR=7.41,95%CI:1.82 ~ 30.15；P=0.005)， KELIM评分HR=5.14,95%CI:1.41 ~ 18.72；P=0.013)为OS时间的独立危险因素。结论：KELIM评分可作为HGSOC患者接受NACT+IDS化疗敏感性、R0切除、PFS时间和OS时间的预测指标。编织毯得分
[Application of CA125 elimination rate constant K score in prognostic forecast of patients undergoing interval debulking surgery for high grade serous ovarian cancer].
Objective: To investigate the predictive value of the cancer antigen 125 (CA125) elimination rate constant K (KELIM) score for no visible residual disease (R0) and prognosis in high-grade serous ovarian carcinoma (HGSOC) patients undergoing neoadjuvant chemotherapy (NACT)+interval debulking surgery (IDS). Methods: A retrospective analysis was conducted on 78 HGSOC patients treated with NACT+IDS at Beijing Hospital, from June 2014 to June 2024. The KELIM score was calculated, and its predictive value for R0 resection, chemotherapy response score (CRS), platinum-free interval (PFI), progression-free survival (PFS) time, and overall survival (OS) time was analyzed. Results: (1) The mean age at diagnosis was (61.9±9.9) years. The mean KELIM score was 1.1±0.4, with 44 patients having KELIM score≥1 and 34 having KELIM score <1. (2) Patients with KELIM score ≥1 had significantly higher rates of R0 resection (84% vs 56%; P=0.006), CRS3 grading (41% vs 0; P<0.001), and PFI ≥6 months (84% vs 53%; P=0.04) compared to those with KELIM score <1. Additionally, the median PFS time (18.7 vs 13.2 months; P<0.001) and OS time (34.8 vs 29.9 months; P=0.007) were significantly longer in the KELIM score ≥1 group. Chemosensitivity: patients with PFI <6 months had a significantly lower median KELIM score than those with PFI ≥6 months (0.8 vs 1.2; P=0.005). Surgical outcome: patients achieving R0 resection had a significantly higher median KELIM score than those without R0 (1.2 vs 0.7; P<0.001). (3) Univariate analysis identified non-R0 resection, CRS3 grading, lack of poly adenosine diphosphate ribose polymerase (PARP) inhibitor maintenance therapy, and KELIM score <1 as significant risk factors for OS time (all P<0.05). Multivariate analysis confirmed non-R0 resection (HR=3.78,95%CI: 1.13-12.66; P=0.031), no PARP inhibitor maintenance (HR=7.41,95%CI:1.82-30.15; P=0.005), and KELIM score <1 (HR=5.14,95%CI:1.41-18.72; P=0.013) as independent risk factors for OS time. Conclusions: The KELIM score may serve as a predictive marker for chemosensitivity, R0 resection, PFS time, and OS time in HGSOC patients undergoing NACT+IDS. KELIM score<1 is an independent risk factor for OS.
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