The role of serum CA-125 levels in early-stage epithelial ovarian cancer on preoperative CT and MRI.
BACKGROUND
We sought to identify the role of serum CA-125 levels in early-stage epithelial ovarian cancer (EOC) on preoperative CT and MRI.


METHODS
Clinical data of 101 patients with early-stage EOC on preoperative CT and MRI were collected between January 2000 and December 2007. Clinical stage I (n=59) was defined as tumor limited to the ovaries with or without ascites, whereas clinical stage II (n=42) was defined as tumor within the pelvis with or without ascites. The primary endpoint was to investigate the efficacy of serum CA-125 levels for the prediction of advanced-stage disease, and secondary endpoints were to evaluate the accuracy of preoperative CT and MRI, and to examine the role of serum CA-125 levels as a prognostic factor for survival.


RESULTS
The results of preoperative CT and MRI were concordant with no peritoneal implants outside the pelvis in 50/101 (50%) and no lymph node metastasis in 71/101 (70%) patients. The receiver operating characteristic curves showed that best cut-off values of serum CA-125 levels were 320 U/ml (71% sensitivity, 84% specificity) and 510 U/ml (67% sensitivity, 80% specificity) for the prediction of peritoneal implants outside the pelvis and lymph node metastasis. The serum CA-125 level (> or =320 U/ml) was a significant factor for the prediction of advanced-stage disease (adjusted OR, 7.43; 95% CI, 2.39-23.04). However, it was not an independent prognostic factor for survival.


CONCLUSIONS
Serum CA-125 levels may be very useful for the prediction of advanced-stage disease in early-stage EOC on preoperative CT and MRI.
Kim
H S
HS
Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, Chongno-Gu, Seoul, Republic of Korea.
Kim
J W
JW
Cho
J Y
JY
Chung
H H
HH
Park
N H
NH
Song
Y S
YS
Kim
S H
SH
Kang
S B
SB
D000230:Adenocarcinoma / Q000097:blood* / Q000175:diagnosis / Q000473:pathology; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D018394:CA-125 Antigen / Q000097:blood*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000473:pathology; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed
D000970:Antineoplastic Agents; D018394:CA-125 Antigen