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

Authors He C, Thapa N, Wang Y, Song Z, Yang J, Xu M, Zuo N, Cai H

Received 19 July 2019

Accepted for publication 17 February 2020

Published 25 March 2020 Volume 2020:12 Pages 2223—2230


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Beicheng Sun

Can He,1 Niresh Thapa,1,2 Yang Wang,1 Ziye Song,1 Jing Yang,1 Mengfei Xu,1 Na Zuo,1 Hongbing Cai1

1Department 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; 2Karnali Academy of Health Sciences, Jumla, Nepal

Correspondence: Can He; Hongbing Cai Email;

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: epithelial ovarian cancer, peritoneal carcinomatosis index, resectability, cancer antigen 125, primary debulking surgery

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