tjcl Turkish Journal of Clinics and Laboratory 2149-8296 DNT Ortadoğu Yayıncılık A.Ş. 10.18663/tjcl.1802567 Chemotherapy Kemoterapi İleri Evre Over Kanserinde Kemosensitivite ve Sağkalımı Öngörmede KELIM Skorunun Gerçek Yaşam Geçerliliğinin Değerlendirilmesi Real-World Validation of the KELIM Score for Predicting Chemosensitivity and Survival in Advanced Ovarian Cancer https://orcid.org/0000-0002-1268-6666 Bakkal Temi Yasemin KOCAELİ ÜNİVERSİTESİ, TIP FAKÜLTESİ https://orcid.org/0000-0002-0515-766X Çitakkul İlkay KOCAELI UNIVERSITY https://orcid.org/0000-0001-8527-936X Baydar Ece KOCAELI UNIVERSITY https://orcid.org/0000-0002-5875-7546 Balcı Sibel KOCAELI UNIVERSITY https://orcid.org/0000-0002-7871-6311 Çabuk Devrim KOCAELI UNIVERSITY https://orcid.org/0000-0001-6126-5377 Kefeli Umut KOCAELI UNIVERSITY https://orcid.org/0000-0002-4339-9918 Uygun Kazım KOCAELI UNIVERSITY 01 01 2026 16 4 564 569 10 13 2025 11 15 2025 Copyright © 2010, Turkish Journal of Clinics and Laboratory 2010 Turkish Journal of Clinics and Laboratory

Amaç: Bu çalışmada, ileri evre epitelyal over kanserli hastalarda CA-125 kinetiklerinden türetilen KELIM skorunun sağkalım öngörüsündeki prognostik değerini gerçek yaşam verileriyle değerlendirmeyi amaçladık.Gereç ve Yöntem: Bu retrospektif çalışmada, 2017–2024 yılları arasında evre III–IV over kanseri tanısı alarak platin bazlı kemoterapi ile tedavi edilen 238 hasta incelendi. Tedavinin ilk 100 günü içerisindeki CA-125 kinetiklerinden hesaplanan KELIM skorları, ROC analizi sonuçlarına göre yüksek (≥0.9, olumlu) ve düşük (≤0.9, olumsuz) olarak sınıflandırıldı. Sağkalım sonuçları Kaplan-Meier ve Cox regresyon analizleri ile değerlendirildi.Bulgular: KELIM skorları düşük olan hastalar, yüksek skorlu hastalara göre anlamlı olarak daha kısa medyan genel sağkalım (33 ay ,68 ay, p < 0,001) ve progresyonsuz sağkalım (11 ay vs. 18 ay, p < 0,001) sürelerine sahipti. Çok değişkenli Cox regresyon analizi, düşük KELIM skorunun genel sağkalımın kötü olmasının önemli bir belirleyicisi olduğunu ortaya koydu (HR, 4,062; %95 CI, 2,711–6,087; p < 0,001). Ayrıca, düşük KELIM skoru olan hastalarda (89,4%) hastalık ilerlemesi, yüksek KELIM skoru olan hastalara (69,9%, p = 0,001) göre daha sık görülmüştür. Ayrıca, hastalık progresyonu düşük KELIM grubunda (%89.4) yüksek KELIM grubuna (%69.9) göre daha sık gözlendi (p = 0.001).Sonuç: KELIM skoru, standart kemoterapiden fayda görme olasılığı düşük olan hastalar için erken tedavi kararlarına bilgi sağlayabilecek, ileri evre yumurtalık kanseri için pratik ve erişilebilir bir prognostik biyomarker görevi görmektedir. Kişiselleştirilmiş tedavi stratejilerinde KELIM skorunun rolünü doğrulamak için ileriye dönük çalışmalara ihtiyaç vardır.

Aim: We evaluated the prognostic significance of the KELIM score, which is derived from CA-125 kinetics, in predicting survival outcomes among patients with advanced epithelial ovarian cancer in a real-world clinical context.Material and Methods: This retrospective study analyzed 238 patients with stage III-IV ovarian cancer treated between 2017-2024. KELIM scores, calculated from CA-125 kinetics during the first 100 treatment days, were categorized as high (favorable, >0.9) or low (unfavorable, ≤0.9) based on the ROC analysis. Survival outcomes were assessed using Kaplan-Meier and Cox regression analyses.Results: Patients with low KELIM scores had significantly shorter median overall survival (33 vs. 68 months, p < 0.001) and progression-free survival (11 vs. 18 months, p < 0.001) than those with high scores. Multivariate Cox regression analysis identified a low KELIM score as a significant predictor of poor overall survival (HR, 4.062; 95% CI, 2.711–6.087; p < 0.001). Additionally, disease progression was more frequent in patients with a low KELIM score (89.4%) than in those with a high KELIM score (69.9%, p = 0.001).Conclusion: The KELIM score serves as a practical and accessible prognostic biomarker for advanced ovarian cancer with the potential to inform early treatment decisions for patients who are unlikely to benefit from standard chemotherapy. Further prospective studies are warranted to validate their roles in personalized therapeutic strategies.

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