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Pre-operative serum CA125, peritoneal cancer index and intra-operative mapping score as predictors of surgical results in primary epithelial ovarian cancer
  1. Mustafa Zelal Muallem1,
  2. Jalid Sehouli1,
  3. Rolf Richter1,
  4. Aygun Babayeva2,
  5. Khayal Gasimli2 and
  6. Asya Parashkevova2
  1. 1 Department of Gynecology with Center for Oncological Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin,Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
  2. 2 Ovarian Cancer Tumor Bank, Virchow Campus Clinic, Charité Medical University, Berlin, Germany
  1. Correspondence to Ass. Prof. Mustafa Zelal Muallem, Department of Gynecology with Center for Oncological Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin,Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Drzelal77{at}outlook.de; Mustafa-Zelal.Muallem{at}charite.de

Abstract

Objective Prediction of post-operative residual disease after ovarian cancer cytoreductive surgery remains a topic of interest to gynecologic oncologists. The aim of this study was to explore the correlation between serum CA125, peritoneal cancer index, and intra-operative mapping of ovarian cancer and their predictive value for post-operative outcome.

Methods A total of 70 patients with primary epithelial ovarian cancer, who underwent primary cytoreductive surgery at Charité, Berlin between January 2013 and February 2014 were included. In all patients, pre-operative CA125 values, intra-operative peritoneal cancer index, and intra-operative mapping of ovarian cancer were determined.

Results Using a receiver operating characteristic analysis, cut-off values for CA125, peritoneal cancer index, and intra-operative mapping of ovarian cancer score could be defined. Patients with pre-operative serum CA125 >600 U/mL had a three times higher risk for residual tumor after primary cytoreductive surgery (p=0.037). A peritoneal cancer index score >20 indicated a nine times increased risk for residual tumor (p=0.003). More than six affected abdominopelvic fields on the intra-operative mapping of ovarian cancer was associated with a 25 times higher risk of residual tumor after primary cytoreductive surgery (p≤0.05). The combination of all three values predicted residual tumor in up to 90% of patients.

Conclusion We found that pre-operative CA125 >600 U/mL, peritoneal cancer index >20, and intra-operative mapping of ovarian cancer score >6 could be used as predictors of complete tumor resection. The combination of all these three values predicted the incomplete resection of disease in up to 90% of patients even in experienced centers.

  • surgical procedures
  • operative
  • cystadenocarcinoma
  • serous
  • peritoneal neoplasms
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Footnotes

  • Correction notice Since this article was first published online, the author Musatafa Zelal Muallem has been updated so that their first name is listed as Mustafa.

  • Contributors MZM and AP co-authored the manuscript and contributed to the study design and data preparation. JS reviewed the text, designed the study and helped write the manuscript. RR conducted the statistical studies and helped write the Methods section. AB and KG collected and prepared the study data.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available in a public, open access repository. All data relevant to the study are included in the article or uploaded as supplementary information.

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