title: CA125 kinetic parameters predict optimal cytoreduction in patients with advanced epithelial ovarian cancer treated with neoadjuvant chemotherapy.
abstract: OBJECTIVE
  To evaluate the different kinetic parameters of serum CA125 during neoadjuvant chemotherapy (NAC) to predict optimal interval debulking surgery (IDS).
  
  
  METHODS
  The present retrospective multicenter study included patients with advanced ovarian cancer treated with neoadjuvant platinum-based chemotherapy followed by IDS between 2002 and 2009. Demographic data, CA125 levels, radiographic data, chemotherapy and surgical-pathologic information were obtained. Univariate and multivariate analyses were performed to evaluate variables associated with complete IDS. ROC analysis was used to determine potential cut-off values to predict the likelihood of complete cytoreduction via IDS.
  
  
  RESULTS
  One hundred and forty-eight patients met the study criteria. Ninety-three patients (62.8%) had optimal cytoreduction with no residual macroscopic disease (CC-0) after IDS. In multivariate analyses, the CA125 level after the 3rd NAC was an independent predictor for optimal cytoreduction (odds ratio: 0.98 [0.97-0.99], p=0.04). The area under the ROC curve was 0.73. A threshold of 75 UI/ml displayed the most predictive power. The odds ratio to predict complete cytoreduction was 3.29 [1.56-7.10] (p=0.0008).
  
  
  CONCLUSIONS
  Our data indicate that for advanced ovarian cancer, a CA125 level less than 75 UI/ml after the 3rd NAC was an independent predictor factor for complete IDS.
authors.affiliation: Department of breast and gynecological surgery, Institut Curie, 26 rue d'Ulm, 75248 Paris cedex, France; Department of gynecology-obstetrics, University Reims Hospital, 45 rue Cognacq Jay, 51092 Reims cedex, France.
authors.forename: Aurélie
authors.initials: A
authors.lastname: Pelissier
authors.affiliation: Department of breast and gynecological surgery, Institut Curie, 26 rue d'Ulm, 75248 Paris cedex, France; Department of gynecological surgery, Tenon Hospital, 4 rue de la Chine, 75020 Paris, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Bonneau
authors.affiliation: Department of surgical oncology, Institut Paoli-Calmettes, 232 bd Sainte Marguerite, 13009 Marseille, France.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Chéreau
authors.affiliation: Department of oncology, Centre René Huguenin, Institut Curie, 35 rue Dailly, 92210 Saint Cloud, France.
authors.forename: Thibault
authors.initials: T
authors.lastname: de La Motte Rouge
authors.affiliation: Department of breast and gynecological surgery, Institut Curie, 26 rue d'Ulm, 75248 Paris cedex, France.
authors.forename: Virginie
authors.initials: V
authors.lastname: Fourchotte
authors.affiliation: Department of gynecological surgery, Tenon Hospital, 4 rue de la Chine, 75020 Paris, France.
authors.forename: Emile
authors.initials: E
authors.lastname: Daraï
authors.affiliation: Department of breast and gynecological surgery, Institut Curie, 26 rue d'Ulm, 75248 Paris cedex, France; Versailles-St-Quentin-en-Yvelines University, EA 7285: Risques cliniques et sécurité en santé des femmes et en santé périnatale, France.
authors.forename: Roman
authors.initials: R
authors.lastname: Rouzier
mesh_terms: D018394:CA-125 Antigen / Q000097:blood*; D000077216:Carcinoma, Ovarian Epithelial; D065426:Cytoreduction Surgical Procedures; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008565:Membrane Proteins / Q000097:blood*; D008875:Middle Aged; D020360:Neoadjuvant Therapy; 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; D012189:Retrospective Studies
chemical_list: D018394:CA-125 Antigen; C451759:MUC16 protein, human; D008565:Membrane Proteins
keywords: CA125; Epithelial ovarian cancer; Neoadjuvant chemotherapy; Optimal cytoreduction; Resectability