Change in CA 125 levels after the first cycle of induction chemotherapy is an independent predictor of epithelial ovarian tumour outcome.
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.
Riedinger
J M
JM
Laboratoire de Biologie Médicale, Centre Georges François Leclerc, Dijon, France. jriedinger@dijon.fnclcc.fr
Bonnetain
F
F
Basuyau
J P
JP
Eche
N
N
Larbre
H
H
Dalifard
I
I
Wafflart
J
J
Ricolleau
G
G
Pichon
M F
MF
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
D018394:CA-125 Antigen