Preoperative Predictive Factors for Complete Cytoreduction and Survival Outcome in Epithelial Ovarian, Tubal, and Peritoneal Cancer After Neoadjuvant Chemotherapy
Preoperative Predictive Factors for Complete Cytoreduction and Survival Outcome in Epithelial Ovarian, Tubal, and Peritoneal Cancer After Neoadjuvant Chemotherapy
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DOI：
10.1097/igc.0000000000000924
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发表时间：
2017-03-01
影响因子：
4.8
通讯作者：
Nam, Joo-Hyun
中科院分区：
文献类型：
--
作者：
Baek, Min-Hyun;Lee, Shin-Wha;Nam, Joo-Hyun
目的：本研究的目的是确定术前预测的完全细胞减少和早期复发和死亡的上皮性卵巢癌，输卵管癌和腹膜癌后新辅助化疗（NACT）。方法：我们进行了回顾性分析85例患者谁经历了3个周期的NACT。结果：肿瘤残留组术前CA-125（42.0 U/mL）高于肿瘤切除组（116.6 U/mL），差异有统计学意义（P = 0.006）; NACT后CA-125下降率在无肿瘤残留组中更高（96.8% vs 89.9%，P= 0.001）。肿瘤残留患者的无病生存率和总生存率低于无肿瘤残留患者。在单因素分析中，IDS前CA-125 ≤ 100 U/mL和NACT后CA-125下降率> 80%是完全减瘤的术前预测因素。在多变量分析中，NACT后CA-125的下降率大于80%是完全细胞减灭术的独立术前预测因素（P = 0.002）。结论：NACT后CA-125水平显著下降和随访影像学进展是肿瘤完全减灭、早期复发和死亡的独立术前预测因子。
Objective: The study aims to identify preoperative predictors of complete cytoreduction and early recurrence and death in epithelial ovarian, tubal, and peritoneal cancer after neoadjuvant chemotherapy (NACT).Methods: We performed a retrospective analysis of 85 patients who underwent 3 cycles of NACT. Patients were divided into 2 groups according to residual tumor at interval debulking surgery (IDS), and clinicopathologic, surgical, and follow-up data were compared.Results: Cancer antigen 125 (CA-125) levels before the IDS after completion of NACT were higher in the residual tumor group (42.0 vs 116.6 U/mL, P = 0.006). The drop rate of CA-125 after NACT was higher in the no residual tumor group (96.8% vs 89.9%, P= 0.001). Patients with residual tumor showed lower disease-free and overall survival outcomes than patients with no residual tumor. In univariate analysis, CA-125 of 100 U/mL or less before IDS and a drop rate after NACT greater than 80% were preoperative predictive factors for complete cytoreduction. In multivariate analysis, a drop rate of CA-125 after NACT greater than 80% was an independent preoperative predictive factor for complete cytoreduction (P = 0.002). Progressive disease on follow-up image during NACT was an independent preoperative predictive factor for early recurrence and death (P < 0.001, both).Conclusions: A significant drop of CA-125 after NACT and progressive disease on follow-up image are independent preoperative predictors for complete cytoreduction and early recurrence and death.