title: Change in CA 125 levels after the first cycle of induction chemotherapy is an independent predictor of epithelial ovarian tumour outcome.
abstract: BACKGROUND
  CA 125 assays enable treatment response monitoring in ovarian cancer.
  
  
  METHODS
  This multicentric study was carried out to assess the prognostic value of the CA 125 change after the first and the second courses of induction chemotherapy (CT). Of the 494 stage IIc-IV patients, 194 had a surgical second look, 397 (80.4%) relapsed and 382 (77.3%) died from cancer. Median (range) follow-up time was 34 months (3-215 months).
  
  
  RESULTS
  In Cox models, CA 125 change after the first course (P < 0.0001), residual tumour (P = 0.003), CA 125 before the second course (P = 0.025) and patients' age (P = 0.048) were independent prognostic factors for overall survival (OS). A normal CA 125 before each of the two first CT courses or a CA 125 decrease >50% after the first course with a normal CA 125 before the second course identify patients with good prognosis. Both criteria retained a significant value in predicting second-look findings by univariate and multivariate analysis (P < 0.0001).
  
  
  CONCLUSIONS
  Among well-established prognostic factors in ovarian cancers, the CA 125 change after first course of CT was independent prognostic factors for both achievement of pathological complete response and OS.
authors.affiliation: Laboratoire de Biologie Médicale, Centre Georges François Leclerc, Dijon, France. jriedinger@dijon.fnclcc.fr
authors.forename: J M
authors.initials: JM
authors.lastname: Riedinger
authors.forename: F
authors.initials: F
authors.lastname: Bonnetain
authors.forename: J P
authors.initials: JP
authors.lastname: Basuyau
authors.forename: N
authors.initials: N
authors.lastname: Eche
authors.forename: H
authors.initials: H
authors.lastname: Larbre
authors.forename: I
authors.initials: I
authors.lastname: Dalifard
authors.forename: J
authors.initials: J
authors.lastname: Wafflart
authors.forename: G
authors.initials: G
authors.lastname: Ricolleau
authors.forename: M F
authors.initials: MF
authors.lastname: Pichon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018394:CA-125 Antigen / Q000097:blood* / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000097:blood* / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D010051:Ovarian Neoplasms / Q000097:blood* / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D024162:Second-Look Surgery; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018394:CA-125 Antigen