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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

 Jung-Yun Lee  ;  Young Shin Chung  ;  Kiyong Na  ;  Hye Min Kim  ;  Cheol Keun Park  ;  Eun Ji Nam  ;  Sunghoon Kim  ;  Sang Wun Kim  ;  Young Tae Kim  ;  Hyun-Soo Kim 
 Journal of Gynecologic Oncology, Vol.28(6) : e73, 2017 
Journal Title
 Journal of Gynecologic Oncology 
Issue Date
Adult ; Aged ; Aged, 80 and over ; Carcinoma/drug therapy* ; Carcinoma/pathology ; Cytoreduction Surgical Procedures ; Disease-Free Survival ; Fallopian Tube Neoplasms/drug therapy* ; Fallopian Tube Neoplasms/pathology ; Female ; Humans ; Middle Aged ; Neoadjuvant Therapy* ; Neoplasm Grading ; Neoplasm Staging ; Neoplasms, Cystic, Mucinous, and Serous/drug therapy* ; Neoplasms, Cystic, Mucinous, and Serous/pathology ; Omentum/surgery ; Ovarian Neoplasms/drug therapy* ; Ovarian Neoplasms/pathology ; Ovariectomy ; Proportional Hazards Models ; Reproducibility of Results ; Retrospective Studies ; Salpingectomy ; Treatment Outcome
Chemotherapy Response Score ; Interval Debulking Surgery ; Neoadjuvant Chemotherapy ; Ovarian Neoplasms ; Progression-free Survival ; Tubo-ovarian High-grade Serous Carcinoma
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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1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실)
Yonsei Authors
김상운(Kim, Sang Wun) ORCID logo https://orcid.org/0000-0002-8342-8701
김성훈(Kim, Sung Hoon) ORCID logo https://orcid.org/0000-0002-1645-7473
김영태(Kim, Young Tae) ORCID logo https://orcid.org/0000-0002-7347-1052
김현수(Kim, Hyun-Soo)
김혜민(Kim, Hye Min) ORCID logo https://orcid.org/0000-0002-2899-9480
남은지(Nam, Eun Ji)
이정윤(Lee, Jung-Yun)
정영신(Chung, Young Shin)
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