Nadir CA-125 concentration in the normal range as an independent prognostic factor for optimally treated advanced epithelial ovarian cancer.
BACKGROUND
The amount of residual disease after surgery is considered the most important factor influencing the survival of patients with advanced epithelial ovarian cancer (adEOC). In optimally treated patients with adEOC, there are no well-established prognostic factors [excluding International Federation of Gynecology and Obstetrics (FIGO) stage]. The aim of this retrospective study is to analyze the prognostic value of the CA-125 nadir after the completion of an optimal primary treatment.


METHODS
Patients treated for adEOC were identified from January 1998 to December 2006.


METHODS
elevated CA-125 at time of diagnosis (>35 kU/l); FIGO stage III-IV treated with optimal primary treatment (residual tumor <1 cm and carboplatin/taxane-based combination chemotherapy); and complete response to optimal primary treatment with normalization of CA-125.


RESULTS
Patients, n = 96: 44 group A (< or =10 kU/l); 52 group B (11-35 kU/l). Median progression-free survival (PFS) was 42 and 20 months for groups A and B, respectively (P = 0.0087). Median overall survival (OS) was 84 and 43 months for groups A and B, respectively (P < 0.0001). The Cox model showed a highly significant impact on PFS and OS in relation to CA-125 nadir levels.


CONCLUSIONS
The CA-125 nadir value is a strong independent prognostic factor for optimally treated adEOC after achieving a complete response.
Department of Medical Oncology, Vall d'Hebron University Hospital, Barcelona, Spain. alprat@vhebron.net
A
A
Prat
M
M
Parera
S
S
Peralta
M A
MA
Perez-Benavente
A
A
Garcia
A
A
Gil-Moreno
J M
JM
Martinez-Palones
I
I
Roxana
J
J
Baselga
J M
JM
Del Campo
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D018394:CA-125 Antigen / Q000097:blood*; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000097:blood* / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D010051:Ovarian Neoplasms / Q000097:blood* / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D010052:Ovariectomy / Q000379:methods; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D024162:Second-Look Surgery; D012680:Sensitivity and Specificity; D013030:Spain; D016019:Survival Analysis; D013997:Time Factors
D014408:Biomarkers, Tumor; D018394:CA-125 Antigen