Objective To investigate the influence factors for recurrence of preoperative neoadjuvant chemotherapy combined with cytoreductive surgery (CRS) in treatment of patients with ovarian cancer within one year after surgery.
Methods Ninety patients with ovarian cancer who underwent CRS treatment were selected as the study objects. Patients with ovarian cancer were followed up for one year after chemotherapy and divided into recurrence group (n=54) and no recurrence group (n=36). The general data (age, stage, etc.) and operation type (laparotomy, laparoscopy, etc.) of the two groups were compared. Then multiple regression analysis was used to analyze the independent risk factors for recurrence in patients with epithelial ovarian cancer after one year follow-up after CRS chemotherapy. The prognostic model of CRS treatment for ovarian cancer was established based on related risk factors.
Results Before operation, the proportion of patients with high stage in the recurrence group was significantly higher than that in the no recurrence group (P < 0.05). The proportion of lymph node dissection in the no recurrence group was significantly higher than that in the recurrence group (P < 0.05). The levels of serum carbohydrate antigen 125(CA125), human epididymal protein 4(HE4), carcinoembryonic antigen (CEA) and anti-Müllerian hormone (AMH) in the recurrence group were significantly higher than those in the no recurrence group (P < 0.05). Multiple regression analysis showed that age, preoperative stage, lymph node dissection and preoperative serum CA125, HE4, CEA and AMH were all influential factors (causality) or association factors (causality) for the recurrence of CRS one year after operation in epithelial ovarian cancer patients (P < 0.05). The analysis of predictive value of CRS in patients with epithelial ovarian cancer at one year after surgery showed that the area under the curve (AUC, 95%CI) of preoperative serum CA125, HE4, CEA and AMH alone and joint prediction were 0.740 (0.516 to 0.937), 0.730 (0.467 to 0.990), 0.731 (0.477 to 0.977), 0.743 (0.515 to 0.967) and 0.884 (0.829 to 0.924), respectively.
Conclusion Serum CA125, HE4, CEA and AMH levels should be monitored in patients with epithelial ovarian cancer during preoperative neoadjuvant chemotherapy. The AUC predicted by the combination of serum CA125, HE4, CEA, and AMH before surgery is higher than that predicted by the above indicators alone. Building a predictive risk model can improve the value of predicting the recurrence of CRS in patients with epithelial ovarian cancer within one year after surgery.
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