Prognostic Value of the KELIM Score Versus Conventional CA-125 Kinetics in Ovarian Cancer: A Systematic Review and Meta-Analysis

Background/Objectives: To compare the prognostic value of the modeled cancer antigen-125 (CA-125) elimination rate constant K (KELIM) with that of conventional CA-125 kinetics (e.g., half-life) in epithelial ovarian cancer.

Methods

PubMed, EMBASE, and Cochrane CENTRAL were searched from inception to 8 July 2026, using terms for ovarian cancer, CA-125 kinetics (KELIM, half-life, nadir), platinum-based chemotherapy, and survival or cytoreduction. Hazard ratios (HRs) and odds ratios (ORs) were pooled using random-effects models.

Results

Thirty-seven studies were included (KELIM, 29; conventional, 8). Favorable KELIM was associated with longer overall survival (HR: 0.54, 95% confidence interval [CI]: 0.47–0.63; 14 cohorts; I2 = 72%; moderate certainty) and progression-free survival (HR: 0.57, 95% CI: 0.51–0.63; 18 cohorts; I2 = 62%) and with complete cytoreduction (OR: 3.34, 95% CI: 2.00–5.55; nine cohorts). Short CA-125 half-life was associated with longer overall survival (HR: 0.48, 95% CI: 0.38–0.60; three cohorts; low certainty); no study assessed both markers in the same cohort. Sensitivity analyses changed the estimates little.