Kharchenko Y. The role of predictor factors in the individualization of combined treatment of patients with common ovarian cancer

The study was based on their own clinical observation of 148 patients at OC III − IV (T3a-сN0-1M0-1) stage. It has been established that the conduct of NACT affects the level of expression of Ki67, mt p53 in patients at III – IV stages of OC. Conduct NACT affects the level of expression of Ki67, p53 mt in patients with OC stage III − IV. A comparative analysis of OC pathomorphism after NACT indicates a more significant inhibition of proliferative tumor properties and activation of apoptosis, an increase in the volume of the damaged tumor after 3–4 cycles of NACT compared to 1–2 cycles of NACT. In all patients with common OC, significant positive correlations were found between Ki67 and mt p53 (r = 0.27; p <0.05), MI and Ki67 (r = 0.91; p <0.05), mt p53 and MI (r = 0.24; p <0.05). The presence of VEGF expression in patients with pulmonary embolism with relapse leads to an increase in apoptosis (mtp53, IA) with the growth of the marker CA-125. We also established a set of essential features in the ratio of values of expression levels of MBM for different types of relapses of OC for the first time. High expression of Ki67, Bcl-2, in combination with a lack of VEGF and moderate expression of mt p53 determines the high risk of loco-regional relapse. The lack of VEGF and Bcl-2 expression with moderate Ki67 expression and high expression of mt p53 determines the high risk of generalization of the process of the abdominal cavity with / or distant metastasis. The lack of Bcl-2 and mt p53 expression in conjunction with the absence or moderate expression of Ki67 and positive VEGF indicates a high risk of marker relapse. For the first time a mathematical model of the individual prognosis of the course of the disease and the results of treatment of patients with OC of III-IV stages was developed. The model is implemented in the form of a computer program with automatic calculation of predicted indicators. We developed the algorithm of combined treatment of patients with the common forms of OC with the account of molecular-biological factors of a tumor. The use of individualized treatment regimens of OC of III − IV (T3a-cN0-1M0-1) stages, depending on the type and risk of recurrence, increased the term of the non-recurring period by 6.7 months in patients with a high risk of loco-regional relapse development. In patients with a high risk of generalization process developing in the abdominal cavity with/ or abstinent metastases this period increased by 13.2 months.