Dr Smith on the Predictive Value of CA-125 KELIM Score for Outcomes With HIPEC in Ovarian Cancer

Gabriella Smith, MD, obstetrician/gynecologist, Cleveland Clinic, discusses key findings from a retrospective study evaluating the predictive value of CA-125 ELIMination Rate Constant K (KELIM) score for survival outcomes with hyperthermic intraperitoneal chemotherapy (HIPEC) at the time of surgery in patients with epithelial ovarian cancer.

The single-institution study compared progression-free survival (PFS) and overall survival (OS) outcomes in patients undergoing HIPEC at time of interval cytoreductive surgery who had an unfavorable pre-HIPEC KELIM score (<1) vs a favorable KELIM ( ≥ 1), Smith begins. Between 2017-2022, 63 patients with primary advanced high grade serous ovarian cancer undergoing neoadjuvant chemotherapy followed by HIPEC at time of interval cytoreductive surgery from the Cleveland Clinic's HIPEC database were included in the evaluation, Smith details.

Results from the study were presented at the 2024 Society of Gynecologic Oncology Winter Meeting, and confirmed that CA-125 KELIM score was predictive of PFS and OS for this patient population, Smith states. Patients with an unfavorable KELIM score were more inclined to undergo modified radical hysterectomy rather than simple hysterectomy during interval debulking surgery (14.8% vs. 0%). However, other surgical procedures did not exhibit significant differences (P > 0.05), she says.

At a median duration of follow-up of 29.9 months (95% CI, 16.3-38.0) for all patients, the median progression-free survival (PFS) for all patients was 15.2 months, while overall survival (OS) was 39.1 months, Smith reports. Notably, patients with a favorable KELIM score had a significantly longer median PFS of 19.7 months compared with 12.3 months for those with an unfavorable score, she adds. Median OS was not reached in patients with a favorable KELIM score, with a significantly higher OS rate of 79.9% at 3 years (95% CI, 65.5-94.4). Conversley, the OS rate was 43.6% (95% CI, 20.9-66.4) in patients with an unfavorable score, Smith states.

Overall, findings were consistent with previous studies which found that KELIM score was predictive of PFS and OS in patients with epithelial ovarian cancer undergoing neoadjuvant chemotherapy, Smith concludes.