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KMID : 1137020170280060004
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Journal of Gynecologic Oncology
2017 Volume.28 No. 6 p.4 ~ p.4
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External validation of chemotherapy response score system for histopathological assessment of tumor regression after neoadjuvant chemotherapy in tubo-ovarian high-grade serous carcinoma
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Lee Jung-Yun
Chung Young-Shin
Na Ki-Yong
Kim Hye-Min
Park Cheol-Keun
Nam Eun-Ji
Kim Sung-Hoon
Kim Sang-Wun
Kim Young-Tae
Kim Hyun-Soo
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Abstract
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Objective: The chemotherapy response score (CRS) system based on histopathological examination has been recently proposed for tubo-ovarian high-grade serous carcinoma (HGSC) to assess response to neoadjuvant chemotherapy (NAC). This study was aimed at validating the CRS system in an external cohort of tubo-ovarian HGSC patients.
Methods: This study included 110 tubo-ovarian HGSC patients who underwent NAC followed by interval debulking surgery. The 3-tiered CRS of the omental and adnexal tissue sections was determined by 3 independent pathologists. Differences in patient outcomes according to CRS were analyzed.
Results: The CRS system was highly reproducible among the 3 pathologists. Fleiss' kappa value and Kendall's coefficient of concordance for the omental CRS were 0.656 and 0.669, respectively. The omental CRS significantly predicted progression-free survival (PFS). The median PFS of patients whose tumors exhibited the omental CRS 1?2 (15 months) was significantly shorter than that of patients with an omental CRS of 3 (19 months; p=0.016). In addition, after adjusting for age, stage, and debulking status, the omental CRS was an independent prognostic factor for PFS of tubo-ovarian HGSC patients who were treated with NAC (adjusted hazard ratio [HR]=1.74; 95% confidence interval [CI]=1.05?2.87).
Conclusion: The CRS system for assessing NAC response was a reproducible prognostic tool in our cohort. The application of the CRS system after NAC can improve survival estimation in HGSC patients.
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KEYWORD
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Ovarian Neoplasms, Tubo-ovarian High-grade Serous Carcinoma, Chemotherapy Response Score, Neoadjuvant Chemotherapy, Interval Debulking Surgery, Progression-free Survival
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