İleri Evre Over Kanserinde Kemosensitivite ve Sağkalımı Öngörmede KELIM Skorunun Gerçek Yaşam Geçerliliğinin Değerlendirilmesi

Yıl 2025, Cilt: 16 Sayı: 4, 564 - 569, 01.01.2026

Yasemin Bakkal Temi , İlkay Çitakkul , Ece Baydar , Sibel Balcı , Devrim Çabuk , Umut Kefeli , Kazım Uygun

https://doi.org/10.18663/tjcl.1802567

Öz

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.

Anahtar Kelimeler

KELIM skoru , epitelyal over kanseri , CA-125 kinetiği , kemoterapiye duyarlılık , prognostik biyobelirteç , gerçek yaşam verileri

Etik Beyan

Bu çalışma, Kocaeli Üniversitesi Etik Kurulu’ndan etik onay almıştır (Onay Kodu: KOÜ GOKAEK-2024/19/06, Proje Numarası: 2024/461). Tüm işlemler Helsinki Bildirgesi ilkelerine uygun olarak gerçekleştirilmiştir.

Destekleyen Kurum

Bu çalışma için özel bir finansman desteği alınmamıştır.

Real-World Validation of the KELIM Score for Predicting Chemosensitivity and Survival in Advanced Ovarian Cancer

Öz

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.

Anahtar Kelimeler

KELIM score , epithelial ovarian cancer , CA-125 kinetics , chemosensitivity , prognostic biomarker , real-world evidence

Etik Beyan

This study received ethical approval from the Institutional Review Board of Kocaeli University (Approval Code: KOÜ GOKAEK-2024/19/06, Project Identifier: 2024/461). All procedures were performed in accordance with the principles of the Declaration of Helsinki.

Destekleyen Kurum

No specific funding was received for this study.

Kaynakça

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