Prognostic value of serum CA125 level change during chemotherapy post-surgery in patients with advanced epithelial ovarian carcinoma

( views:352, downloads:0 )
LAN Chun-yan(Department of Gynecolngic Oneology,Cancer Center,Sun Yat-sen University,Guangzhou 510060,China)
HUANG He(Department of Gynecolngic Oneology,Cancer Center,Sun Yat-sen University,Guangzhou 510060,China)
LIU Ji-hong(Department of Gynecolngic Oneology,Cancer Center,Sun Yat-sen University,Guangzhou 510060,China)
Journal Title:
Volume 43, Issue 10, 2008
Key Word:
Ovarian neoplasms;CA-125 antigen;Heoplasm,residual;Prognosis

Abstract: Objective To investigate the prognostic value of the changes in serum CA125 level during chemotherapy post-surgery in patients with advaneed epithelial ovarian carcinoma.Methods A retrospective analysis was conducted on 142 patients with stage Ⅲ-Ⅳ epithelial ovarian carcinoma who had primary treatment in the Cancer Center of the Sun Yat-sen University during January 1998 to December 2003.The changes in CA125 levels during chemotherapy post-surgery in patients were analyzed.The survival outcomes of patients with various levels of CA125 were studied using Kaplan-Meier method.Multivariate Cox regression model Wag used to aggess the correlations between survival and the change in CA125 level during chemotherapy and other prognostic factors.Results The 3-year overall survival(OS)was 64%,71%,and 64%respectively in patients with different pretreatment CA125 levels(≤500,>500-1500 and>1500 kU/L;P>0.05).The CA125 level was normalized(0-35 kU/L)in 77(54.2%)patients after three cycles of postoperative chemotherapy.It revealed significant differences in 3-year OS(84%vs.42%)and 5-year OS(56%vs.15%)between the patients with normalized and elevated CA125 levels(n=48)after three cycles of chemothempy(P<0.01).Multivariate analysis showed that residual tumor size>1 cm(P<0.01)and elevated CA125 after three-cycle postoperative chemotherapies(P<0.01)were two independent factors related to survival.In the subgroup of optimal cytoreduction(residual tumor size≤1 cm),the 3-year and 5-year OS rate were 88%and 64%for patients with normalized CA125 level after three cycles of chemotherapy respectively,while only 52%and 18%for patients with elevated CA125 level(P<0.01).Similarly,even in the suboptimal cytoreduction group,the 3-year and 5-year OS were also significantly increased for patients with normalized CA125 level after three cycles of chemotherapy post-surgery,as compared with patients with elevated CA125 level(74%vs.33%in 3-year OS,32%vs.13%in 5-year OS;P<0.01).Conclusions CA125 level after three cycles of chemotherapy post-surgery is an independent predictor of survival for advanced ovarian carcinoma.Whatever the patients undergo,optimal or suboptimal cytoreduction,ifthe CA125 becomes normalized after three cycles of chemotherapy,they would have more favorable prognosis than those with elevated CA125 after three cycles of chemotherapy.

  • [1]Piccart MJ,Bertelsen K,James K,et al.Randomized intergroup trial of cisplatin-paclitaxal versus cisplatin-cyclophosphamide in women with advanced epithelial ovarian cancer:three-year results.J Natl Cancer Inst,2000,92:699-708.
  • [2]Brun JL,Feyler A,Chene G,et al.Long-term results and prognostic factors in patients with epithelial ovsrian cancer.Gynecol Oncol,2000,78:21-27.
  • [3]Markman M,Bundy BN,Alberts DS,et al.Phase Ⅲ trial of standard-dose intravenous cisplatin plus paclitaxel versus moderately high-dose carbeplatin followed by intravenous paclitaxel and intraperitoneal cisplatin in small-volume stage Ⅲ ovarian carcinoma:an intergroup study of the Gynecologic Oncology Group,Southwestern Onoology Group,and Eastern Cooperative Oncology Group.J Clin Oncol,2001,19:1001-1007.
  • [4]Bast R C Jr,Klug TL,St John E,et al.A radioimmunoassay using a monoclonal antibody to monitor the course of epithelial ovarian cancer.N Engl J Med,1983,309:883-887.
  • [5]Kenemans P,Yedema CA,Bon GG,et al.CA125 in gnecological pathology:a review.Eur J Obstet Gynecol Reprod Biol,1993,49:115-124.
  • [6]Cooper BC,Sood AK,Davis CS,et al.Preopexative CA125 levels:an independent prognostic factor for epithelial ovarian cancer.Obstet Gyneool,2002,100:59-64.
  • [7]van Dalen A,Favier J,Burges A,et al.Prognostic significance of CA125 and TPS leveb after 3 chemotherapy courses in ovarian cancere patients.Gynecol Oncol,2000,79:444-450.
  • [8]Markman M,Federico M,Liu PY,et al.Significance of early changes in the serum CA-125 antigen level on overall survival in advanced ovarian cancer.Gynecol Oncol,2006,103:195-198.
  • [9]Colakovi(c) S,Lukic V,Mitrovic L,et al.Prognostic value of CA125 kinetics and half-life in advanced ovarian cancer.Int J Biol Markers,2000,15:147-152.
  • [10]Bullar RE,Berman ML,Bloss JD,et al.Serum CA125 regression in epithelial ovarian cancer:correlation with reassessment findings and survival.Gynecol Oncol,1992,47:87-92.
  • [11]Nyvong GB,Mngensen O,Bichel P,et al.Combined prognostic importance of CA 125,histopathologic grade and DNA-index in advanced ovarian cancer.Eur J Gynaecol Oncol,2000,21:569-572.
  • [12]Eisenkop SM,Spirtos NM,Friedman RL,et al.Relative influences of tumor volume before surgery and the cytoreductive outcome on survival for patients with advanced ovarian cancer:a prospective study.Gynecol Oncol,2003,90:390-396.
  • [13]Bristow RE,Tomacruz RS,Armstrong DK,et al.Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era:a meta-analysis.J Clin Oncol,2002,20:1248-1259.
  • [14]Rafii A,Deval B,Geay JF,et al.Treatment of FIGO stage Ⅳ ovsrian carcinoma:results of primary surgery or interval surgery after neondjuvant chemotherapy:a retrospective study.Int J Gynecol Cancer,2007,17:777-783.
  • [15]Ozols RF,Bundy BN,Greer BE,et al.PhaseⅢtrial of carboplatin and paclitaxel compared with cisplatin and paclitaxel in patients with optimally resected stage Ⅲ ovarian cancer:a Gynecologic Oncolngy Group study.J Clin Oncol,2003,21:3194-3200.
  • [16]van der Burg ME,van Lent M,Buyse M,et al.The effect of debulking surgery after induction chemotherapy on the prognosis in advanced epithelial ovarian cancer.Gynecological Cancer Cooperative Group of the European Organization for Research and Treatment of Cancer.N Engl J Med,1995,332:629-634.
  • [17]Rose PG,Nerenstono S,Brady MF,et al.Secondary surgical cytoreduction for advanced ovarian carcinoma.N Engl J Med,2004,351:2489-2497.
WanfangData CO.,Ltd All Rights Reserved
About WanfangData | Contact US
Healthcare Department, Fuxing Road NO.15, Haidian District Beijing, 100038 P.R.China
Tel:+86-010-58882616 Fax:+86-010-58882615