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

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.