title: CA-125 level as a prognostic indicator in type I and type II epithelial ovarian cancer.
abstract: OBJECTIVE
  Most patients with epithelial ovarian cancer achieve a complete clinical remission (CCR) with normal CA-125 but will still relapse and die from their disease. The present study was designed to determine whether CA-125 levels before, during, and after primary treatment provide prognostic information for both type I and type II ovarian cancer.
  
  
  METHODS
  In this retrospective study, we identified 410 patients with epithelial ovarian cancer who had achieved a CCR between 1984 and 2011. A Cox proportional hazards model and log-rank test were used to assess associations between the nadir CA-125, histotype, and prognosis.
  
  
  RESULTS
  The baseline serum CA-125 concentration was higher in patients with type II ovarian cancer than in those with type I ovarian cancer (P < 0.001). The nadir CA-125 was an independent predictor of progression-free survival (PFS; P < 0.001) and overall survival (OS; P = 0.035) duration. The PFS and OS durations were 21.7 and 79.4 months in patients with CA-125 of 10 U/mL or less and 13.6 and 64.6 months in those with CA-125 of 11 to 35 U/mL, respectively (P = 0.01 and P = 0.002, respectively). Histotype was an independent predictor of PFS (P = 0.041): the PFS and OS durations of the patients with type I ovarian cancer were longer than those of the patients with type II ovarian cancer (P < 0.001 and P < 0.001, respectively).
  
  
  CONCLUSIONS
  The nadir CA-125 and histotype are predictive of PFS and OS durations in patients with ovarian cancers who experienced a CCR. Progression-free survival and OS durations were shorter in the patients with CA-125 levels of 11 to 35 U/mL and type II disease than in those with CA-125 levels of 10 U/mL or less and type I ovarian cancer.
authors.affiliation: Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Xiaoxiang
authors.initials: X
authors.lastname: Chen
authors.forename: Jing
authors.initials: J
authors.lastname: Zhang
authors.forename: Wenjun
authors.initials: W
authors.lastname: Cheng
authors.forename: Doo Young
authors.initials: DY
authors.lastname: Chang
authors.forename: Jianfei
authors.initials: J
authors.lastname: Huang
authors.forename: Xuan
authors.initials: X
authors.lastname: Wang
authors.forename: Lizhou
authors.initials: L
authors.lastname: Jia
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Rosen
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.forename: Da
authors.initials: D
authors.lastname: Yang
authors.forename: David M
authors.initials: DM
authors.lastname: Gershenson
authors.forename: Anil K
authors.initials: AK
authors.lastname: Sood
authors.forename: Robert C
authors.initials: RC
authors.lastname: Bast
authors.forename: Jinsong
authors.initials: J
authors.lastname: Liu
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000378:metabolism / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D002288:Adenocarcinoma, Mucinous / Q000378:metabolism / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism; D018394:CA-125 Antigen / Q000378:metabolism*; D002295:Carcinoma, Transitional Cell / Q000378:metabolism / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D018284:Cystadenocarcinoma, Serous / Q000378:metabolism / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D016889:Endometrial Neoplasms / Q000378:metabolism / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000378:metabolism / Q000401:mortality / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000378:metabolism / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen