Can optimal primary cytoreduction be predicted in advanced stage epithelial ovarian cancer? Role of preoperative serum CA-125 level.
The aim of this study was to determine the ability of preoperative serum CA-125 levels to predict optimal cytoreduction in patients with stage III epithelial ovarian cancer. A retrospective review was made of the records of 40 patients with FIGO stage III ovarian carcinoma who underwent primary cytoreductive surgery. A receiver operating characteristic (ROC) curve was used to determine the most useful CA-125 level in predicting optimal versus suboptimal tumour cytoreduction. Twenty-two (55%) patients were optimally cytoreduced (residual disease <or=1 cm). A preoperative serum CA-125 level of 500 U/ml was found to be the value with the most predictive power. Optimal cytoreduction was obtained in 16 of the 21 cases (76%) with a CA-125 <500 U/ml compared to only 6 of the 19 cases (32%) with a CA-125 >500 U/ml. At this threshold, preoperative serum CA-125 level was able to predict optimal versus suboptimal cytoreduction with a sensitivity of 72%, specificity of 73%, positive predictive value of 68%, and negative predictive value of 76%. In the management of patients with advanced epithelial ovarian carcinoma, preoperative serum CA-125 level may help to predict optimal primary cytoreduction and to identify candidates for alternative approaches other than traditional primary cytoreductive surgery, such as neoadjuvant chemotherapy.
Obeidat
Basil
B
Department of Obstetrics and Gynaecology, Jordan University of Science and Technology, Irbid, Jordan. ba1971@juat.edu.jo
Latimer
John
J
Crawford
Robin
R
D000230:Adenocarcinoma / Q000097:blood / Q000601:surgery; D018262:Adenocarcinoma, Clear Cell / Q000097:blood / Q000601:surgery; D002288:Adenocarcinoma, Mucinous / Q000097:blood / Q000601:surgery; D000328:Adult; D000368:Aged; D018394:CA-125 Antigen / Q000097:blood*; D018269:Carcinoma, Endometrioid / Q000097:blood / Q000601:surgery; D018283:Cystadenocarcinoma, Papillary / Q000097:blood / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000097:blood / Q000601:surgery*; D011300:Preoperative Care; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D015996:Survival Rate; D016896:Treatment Outcome
D018394:CA-125 Antigen