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Response evaluation after neoadjuvant therapy: evaluation of chemotherapy response score and serological and/or radiological assessment of response in ovarian cancer patients.

Authors
  • Ramspott, Jan Philipp1, 2
  • Baert, Thaïs3, 4
  • MacKintosh, Michelle Louise5
  • Traut, Alexander3
  • Ataseven, Beyhan3, 6
  • Bommert, Mareike3
  • Heitz, Florian3, 7
  • Plett, Helmut3, 7
  • Schneider, Stephanie3
  • Waltering, Kai-Uwe8
  • Heikaus, Sebastian9
  • Harter, Philipp3
  • du Bois, Andreas3
  • 1 Department of Gynecology and Gynecologic Oncology, Ev. Kliniken Essen-Mitte, Essen, Germany. [email protected] , (Germany)
  • 2 Department of Gynecology and Obstetrics, Münster University Hospital, Münster, Germany. [email protected] , (Germany)
  • 3 Department of Gynecology and Gynecologic Oncology, Ev. Kliniken Essen-Mitte, Essen, Germany. , (Germany)
  • 4 Department of Oncology, Laboratory of Tumor Immunology and Immunotherapy, ImmunOvar Research Group, KU Leuven, Leuven, Belgium. , (Belgium)
  • 5 Department of Gynaecological Oncology, St Mary's Hospital, Manchester University Hospitals NHS Trust, Manchester, UK.
  • 6 Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany. , (Germany)
  • 7 Department of Gynecology, Campus Virchow Clinic, Charité Medical University, Berlin, Germany. , (Germany)
  • 8 Department of Radiology, Ev. Kliniken Essen-Mitte, Essen, Germany. , (Germany)
  • 9 Department of Pathology, Ev. Kliniken Essen-Mitte, Essen, Germany. , (Germany)
Type
Published Article
Journal
Archives of gynecology and obstetrics
Publication Date
Oct 01, 2021
Volume
304
Issue
4
Pages
1021–1032
Identifiers
DOI: 10.1007/s00404-021-06020-y
PMID: 33661392
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The chemotherapy response score (CRS) is a histopathological tool to evaluate response to neoadjuvant chemotherapy (NACT) in high-grade serous ovarian cancer (OC). We critically evaluated the clinical value of CRS and compared its predictive power to standard serological (CA125) and radiological response. A retrospective analysis of 277 OC patients, who received primary chemotherapy, was performed. CRS, serological, and radiological findings were correlated with progression-free (PFS) and overall survival (OS). CRS could be determined in 172 of 277 patients (62.1%). In patients with CRS3, a longer median PFS and OS was observed compared with CRS1/2 patients (31.2 vs. 18.9, P < 0.001; 55.0 vs. 36.1 months, P = 0.050). CA125 and radiological response evaluation were also predictive for PFS and OS. Patients with serological and radiological complete response showed longer PFS (23.0 vs. 14.4, P = 0.011; 21.4 vs. 9.6 months, P < 0.001) and OS (49.5 vs. 29.0, P = 0.003; 45.0 vs. 12.9 months, P < 0.001). Patients with pathological complete response (pCR) had the best median PFS (52.8 months), even compared with non-pCR CRS3 (27.8 months). In the total study cohort, serological, and radiological complete response was better at predicting PFS (hazard ratio 2.23 and 2.77). In this study, evaluation of response to chemotherapy by CRS was not superior to conventional methods (CA125 or radiology). Independent of the evaluation method, response to NACT was predictive of PFS and OS. We observed no added value for CRS as a prognostic marker. The clinical relevance of CRS should be discussed, as no therapeutic consequences result from CRS evaluation. © 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.

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