CA125 regression during neoadjuvant chemotherapy as an independent prognostic factor for survival in patients with advanced ovarian serous adenocarcinoma.
OBJECTIVE
The associations of the CA125 regression rate with initial response to chemotherapy and prognosis remain unclear. We examined the association between CA125 regression in neoadjuvant chemotherapy (NAC) and prognosis.


METHODS
Fifty patients with advanced ovarian cancer (TNM classification TIIIc or M1) who received initial NAC and did not undergo significant cytoreductive surgery were selected for the retrospective analysis, after excluding clear cell carcinoma and mucinous adenocarcinoma putative to be cisplatin-resistant. For each patient, regression coefficient was calculated using all the CA125 levels measured from the day of NAC as day 0 until the day of normalization of CA125 level (<35 IU/ml) or the day of standard surgery. Responder was defined as a regression coefficient of -0.039 or greater (33 cases) and nonresponder as a regression coefficient less than -0.039 (17 cases).


RESULTS
The 3-year survival rate for all 50 cases was 59.3%. When stratified by regression coefficient of CA125 levels, the 3-year survival was 70.5% in responders and 43.3% in nonresponders. Univariate analysis identified the regression coefficient of CA125 as a significant prognostic factor for overall survival (P = 0.012; log lank test). Residual tumor at standard surgery after NAC and absolute CA125 level were not significant prognostic factors.


CONCLUSIONS
Based on the CA125 regression rate, it is possible to stratify TIIIc or M1 ovarian serous adenocarcinoma cases into those with a good prognosis of survival and those with poor prognosis. Regression coefficient of CA125 level greater than -0.039 predicts good 3-year survival after subsequent radical surgeries.
Tate
Shinichi
S
Department of Gynecology, Cancer Institute Hospital, 1-37-1 Kami-Ikebukuro, Toshima-ku, Tokyo 170-8455, Japan. state@triton.ocn.ne.jp
Hirai
Yasuo
Y
Takeshima
Nobuhiro
N
Hasumi
Katuhiko
K
D000328:Adult; D000368:Aged; D018394:CA-125 Antigen / Q000097:blood*; D018284:Cystadenocarcinoma, Serous / Q000097:blood* / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000097:blood* / Q000188:drug therapy* / Q000473:pathology; D011379:Prognosis; D012044:Regression Analysis; D015996:Survival Rate
D018394:CA-125 Antigen