The Changes Of Serum CA125 Might Predict The Outcome Of Interval Debulking Surgery After Neoadjuvant Chemotherapy In Patients With Advanced Epithelial Ovarian Cancer

bjective:To evaluate whether the change of serum CA125 level can predict the resectability of interval debulking surgery (IDS) after neoadjuvant chemotherapy(NACT) in patients with advanced epithelial ovarian cancer(EOC).Methods:We conducted a retrospective review for patients with FIGO stage IIIC and IV EOC who were treated with NACT-IDS between February 2006 and January 2014 in our hospital. Demographic data、 clinical characters、Pathological features and prognosis were obtained. Continuous variables were evaluated by Student’s t test or Mann-Whitney U test, as appropriate. Categorical variables were evaluated by chi square test or Fisher’s exact test as appropriate for category size. Standard univariate analyses was performed, as were multivariable analysis with logistic regression to analyse the independent predictor of optimal IDS. Kaplan-Meier method was used to analyse the prognosis.Results:Among sixty-two patients included,28 (45.2%) achieved optimal IDS. Median age was 53.5 (range 37-73). The median cycle of neoadjuvant chemotherapy was 3(range 1-6). No statistical difference was found of the median serum CA125 levels between suboptimal IDS and optimal IDS either before NACT (1552.2 U/mL vs 1715.5 U/mL,p=0.453) or before IDS (27.25 U/mL vs 26.4 U/mL, p=0.713).Those with optimal IDS achieved longer median Progression free survival (PFS) than those with suboptimal IDS (20 vs 11 months, p<0.001), even though the difference of the median overall survival (OS) between the two arms was not statistically significant (26 vs 15 months, p=0.065). Eighteen of 31patients (58.1%) with serum CA125 decline≥0.9825 achieved optimal IDS compared to 10 of the 31 patients (32.3%) with serum CA125 decline< 0.9825 (p=0.041). Standard univariate analyses and multivariable analysis through logistic regression showed that serum CA125 decline>0.9825 could be an independent predictor of optimal IDS (OR 0.344 (95%CI:0.122±0.970)vs 0.146 (95%CI:0.033±0.640); p 0.044 vs 0.011)Conclusions:Patients who underwent optimal IDS have better prognosis compare to suboptimal IDS. The changes of serum CA125 after neoadjuvant chemotherapy might predict optimal interval debulking surgery in patients with advanced epithelial ovarian cancer.