Article Text
Abstract
Introduction Achieving optimal debulking surgery in advanced EOC is challenging. Assessing the response to chemotherapy to select suitable candidates for IDS remains a dilemma. CA125 is a well-recognized biomarker widely applied to help surgeons make that decision. We aim to investigate whether serum CA125 levels after NACT can predict an optimal IDS in patients with advanced epithelial ovarian cancer (EOC).
Methods A retrospective study between 2017 and 2022 evaluated the response to NACT of patients diagnosed with advanced EOC. Patients are divided according to the levels of Ca125 < 100U/mL (group 1) vs. = > 100U/mL (group 2).
Results Sixty-six patients underwent IDS (stage IIIC and IV); CA125 levels after NACT were < 100 U/mL in 48 patients and = >100 in 18 patients. CT scans showed higher response rates in group 1 (72,7%) vs. group 2 (27,3%), with a significant difference (p= 0,001). Peritoneal Cancer Index was < 10 in 80,4% of cases (group 1) vs. 19,6% in group 2 (p=0,013). Complete surgery was higher in group 1 (77,3%) vs. group 2 (22,7%) without a statistical difference (p= 0.18). There was a significant difference in Overall survival and progression-free survival; in group 1, the median OS was 62 months vs. 31 months in group 2 (p= 0.01); in PFS, The mean rate was 33 months for group 1 vs. 17 months (p= 0.02).
Conclusion/Implications Our study showed that CA125 reduction might reflect chemo responsiveness, but there is no difference in our series in both groups regarding complete surgery.