The Analysis Of Chemotherapy Sensitivity And Prognosis Factors In Advanced Serous Ovarian Cancer

ObjectiveTo explore the relationship between clinicopathologic factors and chemosensitivity as well as prognosis of patients with advanced serous ovarian cancer,such as age,FIGO stage,histological grade,chemotherapy administration route,pretreatment serum CA125 levels,CA125 half-life,residual tumor size after cytoreductive surgery.MethodsThe retrospective study contained 71 patients with advanced serous ovarian cancer which were diagnosed from January 2013 to December 2015 in Qingdao University Affiliated Hospital.The clinical pathological data such as age,FIGO stage,histological grade,chemotherapy administration route,pretreatment serum CA125 levels,CA125 half-life,residual tumor size after cytoreductive surgery and relapse time were extracted from the medical records,and all patients were followed up.By comparing the relationship between clinicopathologic factors and chemosensitivity,ROC curve was used to analyze and obtaine the optimal cut-off value of chemosensitivity,Kaplan-Meier was used to calculate the mean survival time and median survival time,Log-rank test and Cox-proportional hazard regression models were used to test the difference in survival.Results1.Age,pretreatment serum CA125 levels,CA125 half-life,and the size of residual lesions after cytoreductive surgery were the key factors affecting chemotherapy sensitivity in advanced serous ovarian cancer.The optimal cut-off value of age for predicting chemotherapy sensitivity and drug resistance was 60.5 years,the sensitivity was 42.9%,and the specificity was 88.4%.The best cut-off value for serum CA125 levels before treatment was 704.25 U/m,the sensitivity was 86.0% and the specificity was 53.6%.The best cut-off value of CA125 half-life was 19.28 days with a sensitivity of 89.3% and a specificity of 55.8%.2.The median survival time was 44.98 months in patients aged <60.5 years,and 23.89 months in those aged ≥ 60.5 years.The median survival time of patients with pretreatment serum CA125 levels <704.25 U/ml was 23.89 months,and the median survival time of patients with pretreatment serum CA125 levels ≥704.25 U/ml was 44.98 months.The average survival time of patients with CA125 half-life <19.28 days was 45.88 months,which was significantly longer than the average survival time of patients with CA125 half-life ≥19.28 days(34.34 months);the median survival time of patients with residual lesion diameter <1cm was 44.98 months and the median survival time of patients with residual lesion diameter ≥ 1cm was 16.89 months.Those differences were effective in terms of statistics.Multivariate survival analysis showed that the relative risk of pretreatment serum CA125 levels was 0.422,95%CI[0.200-0.893],P=0.024.The relative risk of residual lesion size after tumor cell reduction was 3.489,95% CI [1.510-8.060],P=0.003.The pretreatment serum CA125 level and residual tumor size afte cytoreductive surgery were independent prognostic factors in advanced serous ovarian carcinoma.Conclusion1.The major influencing factors of chemotherapy sensitivity and prognosis in patients with advanced serous ovarian cancer concluded age,pre-treatment serum CA125 levels,CA125 half-life,and residual lesion size after cytoreductive surgery.2.The pretreatment serum CA125 level and residual tumor size afte cytoreductive surgery were independent prognostic factors in advanced serous ovarian carcinoma.Values of CA125 higher than 704.25U/ml and residual tumor diameter less than 1cm in advanced serous ovarian carcinoma resulted in an enhanced survival rate of the paitents.