Significance of serum CA125 and TPS antigen levels for determination of overall survival after three chemotherapy courses in ovarian cancer patients during long-term follow-up.
OBJECTIVE
To evaluate the prognostic significance for overall survival rate for the marker combination TPS and CA125 in ovarian cancer patients after three chemotherapy courses during long-term clinical follow-up.


METHODS
The overall survival of 212 (out of 213) ovarian cancer patients (FIGO Stages I-IV) was analyzed in a prospective multicenter study during a 10-year clinical follow-up by univariate and multivariate analysis.


RESULTS
In patients with ovarian cancer FIGO Stage I (34 patients) or FIGO Stage II (30 patients) disease, the univariate and multivariate analysis of the 10-year overall survival data showed that CA125 and TPS serum levels were not independent prognostic factors. In the FIGO Stage III group (112 patients), the 10-year overall survival was 15.2%; while in the FIGO Stage IV group (36 patients) a 10-year overall survival of 5.6% was seen. Here, the tumor markers CA125 and TPS levels were significant prognostic factors in both univariate and multivariate analysis (p < 0.0001). In a combined FIGO Stage III + FIGO Stage IV group (60 patients with optimal debulking surgery), multivariate analysis demonstrated that CA125 and TPS levels were independent prognostic factors. For patients in this combined FIGO Stage III + IV group having both markers below respective discrimination level, 35.3% survived for more than ten years, as opposed to patients having one marker above the discrimination level where the 10-year survival was reduced to 10% of the patients. For patients showing both markers above the respective discrimination level, none of the patients survived for the 10-year follow-up time.


CONCLUSIONS
In FIGO III and IV ovarian cancer patients, only patients with CA 125 and TPS markers below the discrimination level after three chemotherapy courses indicated a favorable prognosis. Patients with an elevated level of CA 125 or TPS or both markers after three chemotherapy courses showed unfavorable prognosis.
van Dalen
A
A
Institute of Tumor Marker Oncology, Gouda, The Netherlands. TMoncology@yahoo.com
Favier
J
J
Hallensleben
E
E
Burges
A
A
Stieber
P
P
de Bruijn
H W A
HW
Fink
D
D
Ferrero
A
A
McGing
P
P
Harlozinska
A
A
Kainz
Ch
Ch
Markowska
J
J
Molina
R
R
Sturgeon
C
C
Bowman
A
A
Einarsson
R
R
Goike
H
H
D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D018394:CA-125 Antigen / Q000097:blood*; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000097:blood* / Q000188:drug therapy* / Q000601:surgery; D010455:Peptides / Q000097:blood*; D011379:Prognosis; D016019:Survival Analysis
D000970:Antineoplastic Agents; D018394:CA-125 Antigen; D010455:Peptides; C089984:tissue polypeptide specific antigen