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

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

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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Acknowledgements

The authors would like to thank all the members of Gynecological Cancer Research Institute in Korea University. This study was sponsored by Hanmi Pharm Co., Ltd., Republic of Korea.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Guro Hospital, College of Medicine, Korea University, Seoul, Republic of Korea

    Hyun-Woong Cho, Yung-Taek Ouh, Jin Hwa Hong & Jae Kwan Lee

  2. Department of Obstetrics and Gynecology, Kangwon National University School of Medicine, Chuncheon, Republic of Korea

    Yung-Taek Ouh

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  1. Hyun-Woong Cho
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Contributions

HWC summarized available literature and drafted the paper. JHH and YTO collected and analyzed the clinical data. JKL and HWC edited the paper and supervised the research group. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jae Kwan Lee.

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Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

This study was approved by the Institutional Review Boards of Korea University Medical Center (KUGH17256). Institutional Review Boards of Korea University Medical Center allows the use of medical record without informed consent where data are fully anonymized.

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Cho, HW., Ouh, YT., Hong, J.H. et al. Exploring the prognostic significance of preoperative high normocalcemia in epithelial ovarian carcinoma. Arch Gynecol Obstet 303, 803–810 (2021). https://doi.org/10.1007/s00404-020-05834-6

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  • DOI: https://doi.org/10.1007/s00404-020-05834-6

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