Aims Evaluation of the clinical value of the chemotherapy response score (CRS) and comparison with serological response to neoadjuvant chemotherapy (NACT) in FIGO III/IV epithelial ovarian cancer patients.
Methods In a retrospective analysis of 182 patients undergoing interval debulking after NACT response to chemotherapy was evaluated using CRS. CRS values were correlated to preoperative serological (CA125) findings using the GCIG criteria, progression free survival (PFS), and overall survival (OS).
Results In this cohort 29.1 % (53/182) of patients had a CRS3, 47.8 % (87/182) CRS2 and 23.1 % (42/182) CRS1. Patients with CRS3 showed a longer median PFS (31.2 months, P=0.001) and OS (92.1 months, P=0.004) compared to patients with CRS1/2 (19.7 and 39.9 months). A pathological complete remission (pCR) led to a longer median PFS (53.6 months) compared to non-pCR CRS3 (28.2 months). CRS correlated with serological response to NACT (κ=0.126, P=0.014). Patients with serological complete remission showed longer PFS (26.9 months, P=0.033) and OS (65.8 months, P=0.011) compared to patients with partial remission (PR) (18 and 36.1 months), stable (SD), or progressive disease (PD) (14.1 and 29.5 months). We observed no significant differences between PFS and OS based on response to NACT by CRS or CA125 (CRS1/2 vs. CA125-SD/PR and CRS3 vs. CA125-CR).
Conclusion In our cohort both serological response and CRS correlated with prognosis. We observed no added value for CRS as a prognostic marker in comparison to evaluation of serological response to NACT. As currently no therapeutic consequences result from CRS the clinical relevance of CRS should be discussed.
