Prognostic Significance of Log(CA125)/PCI for the Resectability of Epithelial Ovarian Cancer: A Retrospective Study

Can He; Niresh Thapa; Yang Wang; Ziye Song; Jing Yang; Mengfei Xu; Na Zuo; Hongbing Cai

doi:10.2147/CMAR.S223519

Prognostic Significance of Log(CA125)/PCI for the Resectability of Epithelial Ovarian Cancer: A Retrospective Study

Cancer Manag Res. 2020 Mar 25:12:2223-2230. doi: 10.2147/CMAR.S223519. eCollection 2020.

Authors

Can He¹, Niresh Thapa^{1

2}, Yang Wang¹, Ziye Song¹, Jing Yang¹, Mengfei Xu¹, Na Zuo¹, Hongbing Cai¹

Affiliations

¹ Department of Gynecological Oncology, Zhongnan Hospital of Wuhan University, Hubei Cancer Clinical Study Center, Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan 430071, Hubei, People's Republic of China.
² Karnali Academy of Health Sciences, Jumla, Nepal.

Abstract

Objective: This study aimed to evaluate the roles of the ratio of log(serum CA125 level)/PCI in epithelial ovarian cancer.

Methods: This is a retrospective study. Data were retrieved for patients with epithelial ovarian cancer who received primary debulking surgeries (PDS) between January 2014 and December 2017 in Zhongnan Hospital of Wuhan University. The PCI and CA125 were determined retrospectively using surgical reports, histological findings, and intraoperative photographic documentation. Survival analysis and ROC curves were applied to evaluate the roles of the ratio of log(serum CA125 level)/PCI in epithelial ovarian cancer.

Results: A total of 69 patients were included. Of these, serous ovarian cancer and mucinous carcinoma accounted for 63.8% (n=44) and 31.9% (n=22), respectively. The remaining patients had clear cell carcinoma (2.9%, n=2) and endometrioid carcinoma ( 1.4%, n= 1). Kaplan-Meier survival analysis showed that log(serum CA125 level)/PCI (log-rank p=0.018) were prognostic factors for OS. Cox regression analysis, otherwise, suggested that only stages were an independent factor of PFS (P=0.02, 95% CI 0.043-0.763); outcomes of cytoreductive surgery could only affect OS significantly (P=0.009, 95% CI 1.639-31.016). Binary logistic regression discovered that only log(serum CA125 level)/PCI was an independent risk factor of PDS. We further used the ROC curve to find that log(serum CA125 level)/PCI could correctly predict the resectability of PDS with AUC 0.781.

Conclusion: The ratio of log(CA125)/PCI that combined the tumor burden and characteristics of peritoneal carcinoma of ovarian origin can predict the resectability of PDS in epithelial ovarian cancer.

Keywords: cancer antigen 125; epithelial ovarian cancer; peritoneal carcinomatosis index; primary debulking surgery; resectability.