title: A new prognostic model for FIGO stage 1 epithelial ovarian cancer.
abstract: BACKGROUND
  No consensus exists which patients with surgical stage 1 epithelial ovarian should receive postoperative chemotherapy. The purpose of this study was to evaluate the prognostic impact of preoperative CA-125 and to establish a prognostic index to identify patients in different risk categories.
  
  
  METHODS
  Data of 600 surgically staged patients with FIGO stage 1 EOC treated in eleven gynecological cancer centers in Australia, the USA and Europe were analyzed. Eligible patients include those with invasive EOC where a preoperative CA-125 was obtained and standard surgical staging performed. Overall survival (OS) was chosen as study endpoint. Preoperative CA-125 values were compared with other prognostic factors, and univariate and multivariate Cox models were calculated.
  
  
  RESULTS
  Two hundred and one patients (33.5%) had preoperative CA-125 < or =30 U/ml and CA-125 levels < or =30 U/ml were associated with lower grade, sub-stage 1A and mucinous histologic cell type. Patients with elevated CA-125 levels were more likely to receive chemotherapy. OS probability was 95% and 85% for patients with pretreatment CA-125 < or =30 U/ml and >30 U/ml, respectively (p 0.003). Multivariate analysis confirmed preoperative serum CA-125 >30 U/ml (OR 2.7) and age at diagnosis >70 years (OR 2.6) as the only independent predictors for overall survival.
  
  
  CONCLUSIONS
  Pretreatment of CA-125 < or =30 U/ml dominates over histologic cell type, sub-stage and grade to identify a subgroup of FIGO stage 1 patients with a genuinely good prognosis with extremely good survival and who could possibly be spared with adjuvant chemotherapy.
authors.affiliation: Queensland Centre for Gynaecological Cancer, Medical School University of Queensland, Royal Brisbane Hospital, Brisbane, Australia. andreas_obermair@health.qld.gov.au
authors.forename: Andreas
authors.initials: A
authors.lastname: Obermair
authors.forename: Arlan
authors.initials: A
authors.lastname: Fuller
authors.forename: Elisa
authors.initials: E
authors.lastname: Lopez-Varela
authors.forename: Toon
authors.initials: T
authors.lastname: van Gorp
authors.forename: Ignace
authors.initials: I
authors.lastname: Vergote
authors.forename: Lynne
authors.initials: L
authors.lastname: Eaton
authors.forename: Jeff
authors.initials: J
authors.lastname: Fowler
authors.forename: Michael
authors.initials: M
authors.lastname: Quinn
authors.forename: Ian
authors.initials: I
authors.lastname: Hammond
authors.forename: Donald
authors.initials: D
authors.lastname: Marsden
authors.forename: Anthony
authors.initials: A
authors.lastname: Proietto
authors.forename: Jonathan
authors.initials: J
authors.lastname: Carter
authors.forename: Margaret
authors.initials: M
authors.lastname: Davy
authors.forename: Lee
authors.initials: L
authors.lastname: Tripcony
authors.forename: Nadeem
authors.initials: N
authors.lastname: Abu-Rustum
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018394:CA-125 Antigen / Q000096:biosynthesis; D016190:Carboplatin / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000097:blood / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D011379:Prognosis
chemical_list: D018394:CA-125 Antigen; D003520:Cyclophosphamide; D016190:Carboplatin; D002945:Cisplatin