Ca125 KELIM as a Potential Tool for Predicting Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Benefit at Interval Cytoreductive Surgery for Advanced Epithelial Ovarian Cancer—A Propensity Score–Matched Analysis

OBJECTIVE: The aim of the study was to explore the role of KELIM as a potential clinical biomarker to help select patients who would benefit with the addition of Hyperthermic intraperitoneal chemotherapy(HIPEC) at interval cytoreductive surgery following neoadjuvant chemotherapy. METHODS: This was a multi-institutional, retrospective observational study of 265 patients with Stage IIIC and Stage IV A high grade serous epithelial ovarian cancer who had undergone interval cytoreductive surgery following neoadjuvant chemotherapy. Propensity score matching was performed to reduce confounding by indication for HIPEC. Matching variables were age, FIGO stage, surgical PCI, and NACT cycles. Univariable and multivariable cox-regression models were created to assess predictors of survival. Survivals were analysed using Kaplan-Meier curves. RESULTS: The median OS and median DFS of patients with Low KELIM score and who received HIPEC was 38 months and 18.9 months respectively as compared to Median OS = NR and DFS of 39.7 months respectively in patients with a high KELIM score who received HIPEC. Patients with low KELIM did worse with the addition of HIPEC (3 year OS-61%, DFS 15%) as compared to patients with High KELIM and HIPEC (3 year OS 90%, DFS- 54%). CONCLUSION: KELIM may help to identify patients who are likely to benefit from the addition of HIPEC at interval cytoreductive surgery. However, these findings require validation in larger prospective studies.