title: Clinical significance of serum CA125 in diffuse malignant mesothelioma.
abstract: BACKGROUND
  Malignant mesothelioma (MM) is a rare and fatal neoplasm. For diffuse malignant mesothelioma (DMM) patients that were not suitable for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy, systemic chemotherapy is the main treatment. There are no convenient tumor markers to predict the efficacy of treatment and disease progression. This study aimed to evaluate serum CA125 level as a biochemical marker of response to therapy and prognosis in patients with DMM.
  
  
  METHODS
  A retrospective study was performed in a single medical institution from April 2008 to April 2014. Overall survival (OS) and prognostic factors were assessed.
  
  
  RESULTS
  Forty-one patients were included with a median age of 53 years. The median OS of all patients was 10 months. Patients with baseline CA125 > 280 U/ml had worse OS compared with the patients that baseline CA125 ≤ 280 U/ml. Baseline level of CA125, stage of disease, primary tumor location and systemic chemotherapy were independent prognostic factors associated with OS. In patients who received systemic chemotherapy, the decline in serum CA125 was associated with favorable OS and objective response according to modified Response Evaluation Criteria in Solid Tumors criteria.
  
  
  CONCLUSIONS
  The baseline level of serum CA125, accompanied with stage of disease, primary tumor location and systemic chemotherapy, could be regarded as independent prognostic factors for DMM patients. Otherwise, the change in serum CA125 can predict OS and response to systemic chemotherapy.
authors.affiliation: Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, No. 37, Guoxue Xiang Street, Chengdu, 610041 Sichuan Province China ; West China School of Medicine, Sichuan University, Chengdu, Sichuan China.
authors.forename: Xu
authors.initials: X
authors.lastname: Cheng
authors.affiliation: Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, No. 37, Guoxue Xiang Street, Chengdu, 610041 Sichuan Province China.
authors.forename: Hong-Feng
authors.initials: HF
authors.lastname: Gou
authors.affiliation: Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, No. 37, Guoxue Xiang Street, Chengdu, 610041 Sichuan Province China.
authors.forename: Ji-Yan
authors.initials: JY
authors.lastname: Liu
authors.affiliation: Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, No. 37, Guoxue Xiang Street, Chengdu, 610041 Sichuan Province China.
authors.forename: De-Yun
authors.initials: DY
authors.lastname: Luo
authors.affiliation: Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, No. 37, Guoxue Xiang Street, Chengdu, 610041 Sichuan Province China.
authors.forename: Meng
authors.initials: M
authors.lastname: Qiu
keywords: CA-125 antigen; Drug therapy; Mesothelioma; Prognosis