Ratio of serum CA125 to Radiological Peritoneal Carcinomatous Index as a novel marker of response to neo adjuvant chemotherapy and predictive model

Dr Prem Kumar Devdoss; Dr Prasanna Srinivasa Rao H; Dr N.Roobalakshmi

Volume : X, Issue : VIII, August - 2020

Ratio of serum CA125 to Radiological Peritoneal Carcinomatous Index as a novel marker of response to neo adjuvant chemotherapy and predictive model

Dr Prem Kumar Devdoss, Dr Prasanna Srinivasa Rao H, Dr N. Roobalakshmi

Abstract :

Ratio of serum CA125 to Radiological Peritoneal Carcinomatous Index as a novel marker of response to neo adjuvant chemotherapy and predictive model of surgical outcome in advanced epithelial ovarian cancer– a single instituitional study. Objective: The objective of this retrospective study is to develop a novel marker– ratio of serum CA 125 to peritoneal carcinomatous index(PCI) – to predict the response in women receiving neoadjuvant chemotherapy for newly diagnosed advanced epithelial ovarian cancer at our centre. Methods: Medical records of women who were newly diagnosed with inoperable advanced ovarian cancer stages III and IV at our centre were selected. Only people with completely documented records in the years 2017 & 2018 were selected. Only patietns with serous histology were chosen. Pre chemotherapy serum CA125 value was noted. Radiological PCI was calculated by reviewing the CECT films & reports of the patients. Patients were compared with the ratio of CA125 to radiological PCI and clinical & pathological response to neo adjuvant chemotherapy. All patients received standard doses of three weekly Paclitaxel and Carboplatin based chemotherapy. Based on the ratio of CA125 to PCI patients were divided into 2 groups – ratio more than 100 and less than 100. Results: A total of 34 were patients were found to meet the eligible criteria. Response assessment was done after 3 to 4 cycles of neoadjuvant chemotherapy. The overall response rate to neoadjuvant chemotherapy in patients in group 1 ( CA125/PCI ratio > 100) was significantly higher as compared to patients in group 2 (CA125/PCI ratio <100). Conclusion: In summary, CA 125 to PCI ratio is novel method to predict response to chemotherapy in advanced epithelial ovarian cancers. This value is a helpful measurement that allows the clinicians to measure the degree of chemosensitivity prior to cytoreductive surgery. This measures the inherent tumor biology and to aids in surgical decision making regarding the role and extent of cytoreduction as well as alternate systemic/local therapies.