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Exploring the prognostic significance of preoperative high normocalcemia in epithelial ovarian carcinoma

Authors
Cho, Hyun-WoongOuh, Yung-TaekHong, Jin HwaLee, Jae Kwan
Issue Date
Mar-2021
Publisher
Springer Verlag
Keywords
Ionized calcium; High normocalcemia; Epithelial ovarian cancer; Predictive biomarker
Citation
Archives of Gynecology and Obstetrics, v.303, no.3, pp 803 - 810
Pages
8
Indexed
SCIE
SCOPUS
Journal Title
Archives of Gynecology and Obstetrics
Volume
303
Number
3
Start Page
803
End Page
810
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/33986
DOI
10.1007/s00404-020-05834-6
ISSN
0932-0067
1432-0711
Abstract
Purpose We investigated the association between serum ionized calcium and prognosis of EOC and determined the optimal cutoff value of ionized calcium level to predict the prognosis of EOC. Methods The medical records of patients who were newly diagnosed with EOC from 2001 to 2016 were retrieved. Preoperative ionized calcium test was performed within 2 weeks before surgery, and the cutoff of high normocalcemia was defined based on the receiver operating characteristic (ROC) curve for recurrence. Cox proportional hazards regression models were used to identify independent prognostic factors for progression-free survival (PFS). Results From 2001 to 2016, 83 patients diagnosed with EOC were identified at a single institution. The optimal cutoff value was set to 4.7 mg/dL (high normocalcemia vs. control group) by plotting the ROC curve for recurrence. Stages III/IV were more frequent in high normocalcemia, with borderline significance (72.9% vs. 52.2%, p = 0.053). Recurrence (67.6% vs. 43.5%, p = 0.029) and death (46.0% vs. 15.2%, p < 0.01) were significantly more frequent in the high normocalcemia group. In multivariate analysis, high normocalcemia (HR 1.9, 95% CI 1.03–3.61, p = 0.04), age (HR 1.04, 95% CI 1.01–1.08, p = 0.02), stage (HR 3.67, 95% CI 1.13–11.92, p = 0.03), residual tumor > 1 cm (HR 3.79, 95% CI 1.61–8.95, p < 0.01), and lymph node metastasis (HR 2.46, 95% CI 1.27–4.78, p < 0.01) were independent risk factors for recurrence. Conclusion This study showed positive association between relatively high level of ionized calcium level and recurrence risk of EOC. High normocalcemia showed the potential as a biomarker for prognosis of EOC.
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Hong, Jin Hwa
Guro Hospital (Department of Obstetrics and Gynecology, Guro Hospital)
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