E-Cadherin Expression and KELIM Score as Predictive and Prognostic Factors for Platinum Sensitivity in Locally Advanced Epithelial Ovarian Cancer.

Abstract

Background: 

Success of treatment in stage III: IV epithelial ovarian cancer depends on chemotherapy (CTH) sensitivity and complete cyto-reductive surgery (CRS). There is a need for predictors of the tumor-primary chemosensitivity and the risk of subsequent platinum-resistant relapse. The predictive values of CA-125 decline percentages during treatments were area of ongoing investigations with inconsistent outcomes.

Methods:

The CA-125 serum concentrations and E-cadherin immunohistochemical expression were prospectively evaluated in locally advanced epithelial ovarian cancer planned for neo-adjuvant chemotherapy followed by interval debulking surgery. The CA-125 elimination rate constant K (KELIM) score and E-cadherin predictive value in relation to the tumor response rate, likelihood of complete IDS, risk of subsequent platinum-resistant relapse, and overall survival (OS) were assessed using univariate and multivariate tests.

Results:

The data from 86 patients were analyzed. KELIM was an independent and major predictor of subsequent platinum resistant relapse risk, and of survivals. In patients with highly chemo-sensitive diseases, the patient prognosis was driven more by the chemotherapy-induced antitumor effects than by the surgery.

CA125 normalization at the end of the neo-adjuvant CTH had a strong impact on OS (p=0.004). Notably favorably KELIM score had better numerical OS (p=0.061).

Conclusion:

KELIM score is a crucial predictor of platinum resistance and OS in chemo-sensitive patients. The presence of ascites and CA125 normalization after neo-adjuvant CTH significantly impact OS. Favorable KELIM score is associated with better survival outcomes.