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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. Conclusions: KELIM is a consistent prognostic factor in ovarian cancer. Its similarity to CA-125 half-life rests on an indirect comparison with older cohorts and does not establish equivalence or superiority. Evidence that KELIM predicts treatment benefit remains exploratory.
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Chen et al. (2026) studied this question.
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