Aurélie Pelissier1, Claire Bonneau2, Elisabeth Chéreau3, Thibault de La Motte Rouge4, Virginie Fourchotte5, Emile Daraï6, Roman Rouzier7. 1. Department of breast and gynecological surgery, Institut Curie, 26 rue d'Ulm, 75248 Paris cedex, France; Department of gynecology-obstetrics, University Reims Hospital, 45 rue Cognacq Jay, 51092 Reims cedex, France. 2. Department of breast and gynecological surgery, Institut Curie, 26 rue d'Ulm, 75248 Paris cedex, France; Department of gynecological surgery, Tenon Hospital, 4 rue de la Chine, 75020 Paris, France. 3. Department of surgical oncology, Institut Paoli-Calmettes, 232 bd Sainte Marguerite, 13009 Marseille, France. 4. Department of oncology, Centre René Huguenin, Institut Curie, 35 rue Dailly, 92210 Saint Cloud, France. 5. Department of breast and gynecological surgery, Institut Curie, 26 rue d'Ulm, 75248 Paris cedex, France. 6. Department of gynecological surgery, Tenon Hospital, 4 rue de la Chine, 75020 Paris, France. 7. Department of breast and gynecological surgery, Institut Curie, 26 rue d'Ulm, 75248 Paris cedex, France; Versailles-St-Quentin-en-Yvelines University, EA 7285: Risques cliniques et sécurité en santé des femmes et en santé périnatale, France.
Abstract
OBJECTIVE: To evaluate the different kinetic parameters of serum CA125 during neoadjuvant chemotherapy (NAC) to predict optimal interval debulking surgery (IDS). METHODS: The present retrospective multicenter study included patients with advanced ovarian cancer treated with neoadjuvant platinum-based chemotherapy followed by IDS between 2002 and 2009. Demographic data, CA125 levels, radiographic data, chemotherapy and surgical-pathologic information were obtained. Univariate and multivariate analyses were performed to evaluate variables associated with complete IDS. ROC analysis was used to determine potential cut-off values to predict the likelihood of complete cytoreduction via IDS. RESULTS: One hundred and forty-eight patients met the study criteria. Ninety-three patients (62.8%) had optimal cytoreduction with no residual macroscopic disease (CC-0) after IDS. In multivariate analyses, the CA125 level after the 3rd NAC was an independent predictor for optimal cytoreduction (odds ratio: 0.98 [0.97-0.99], p=0.04). The area under the ROC curve was 0.73. A threshold of 75 UI/ml displayed the most predictive power. The odds ratio to predict complete cytoreduction was 3.29 [1.56-7.10] (p=0.0008). CONCLUSION: Our data indicate that for advanced ovarian cancer, a CA125 level less than 75 UI/ml after the 3rd NAC was an independent predictor factor for complete IDS.
OBJECTIVE: To evaluate the different kinetic parameters of serum CA125 during neoadjuvant chemotherapy (NAC) to predict optimal interval debulking surgery (IDS). METHODS: The present retrospective multicenter study included patients with advanced ovarian cancer treated with neoadjuvant platinum-based chemotherapy followed by IDS between 2002 and 2009. Demographic data, CA125 levels, radiographic data, chemotherapy and surgical-pathologic information were obtained. Univariate and multivariate analyses were performed to evaluate variables associated with complete IDS. ROC analysis was used to determine potential cut-off values to predict the likelihood of complete cytoreduction via IDS. RESULTS: One hundred and forty-eight patients met the study criteria. Ninety-three patients (62.8%) had optimal cytoreduction with no residual macroscopic disease (CC-0) after IDS. In multivariate analyses, the CA125 level after the 3rd NAC was an independent predictor for optimal cytoreduction (odds ratio: 0.98 [0.97-0.99], p=0.04). The area under the ROC curve was 0.73. A threshold of 75 UI/ml displayed the most predictive power. The odds ratio to predict complete cytoreduction was 3.29 [1.56-7.10] (p=0.0008). CONCLUSION: Our data indicate that for advanced ovarian cancer, a CA125 level less than 75 UI/ml after the 3rd NAC was an independent predictor factor for complete IDS.
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