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Preoperative Predictive Factors for Complete Cytoreduction and Survival Outcome in Epithelial Ovarian, Tubal, and Peritoneal Cancer After Neoadjuvant Chemotherapy
  1. Min-Hyun Baek, MD, PhD*,,
  2. Shin-Wha Lee, MD, PhD,
  3. Jeong-Yeol Park, MD, PhD,
  4. Chae Chun Rhim, MD, PhD*,
  5. Dae-Yeon Kim, MD, PhD,
  6. Dae-Shik Suh, MD, PhD,
  7. Jong-Hyeok Kim, MD, PhD,
  8. Yong-Man Kim, MD, PhD,
  9. Young-Tak Kim, MD, PhD and
  10. Joo-Hyun Nam, MD, PhD
  1. *Department of Obstetrics and Gynecology, Hallym University Sacred Heart Hospital, Anyang; and
  2. Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
  1. Address correspondence and reprint requests to Dae-Yeon Kim, MD, PhD, Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Korea. E-mail:


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.

  • Ovarian cancer
  • Complete cytoreduction
  • Survival outcome
  • Predictive factor
  • Neoadjuvant chemotherapy
  • Interval debulking surgery

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  • The authors declare no conflicts of interest.