Yonsei Med J.  2016 May;57(3):580-587. 10.3349/ymj.2016.57.3.580.

Clinical Significance of CA125 Level after the First Cycle of Chemotherapy on Survival of Patients with Advanced Ovarian Cancer

• Lee M
• Chang MY
• Yoo H
• Lee KE
• Chay DB
• Cho H
• Kim S
• Kim YT
• Kim JH

• KMID: 2374075
• DOI: http://doi.org/10.3349/ymj.2016.57.3.580

Abstract

PURPOSE
To determine the most powerful cancer antigen 125 (CA125)-related prognostic factor for advanced epithelial ovarian cancer (EOC) and to identify cut-off values that distinguish patients with a poor prognosis from those with a good prognosis.
MATERIALS AND METHODS
We included 223 patients who received staging laparotomy and were diagnosed with stage IIC-IV serous EOC. Cox regression analysis was used to determine the most significant prognostic factor among the following variables: serum CA125 before surgery and after the first, second, and sixth cycles of chemotherapy; the nadir CA125 value; the relative percentage change in CA125 levels after the first and second cycles of chemotherapy compared to baseline CA125; CA125 half-life; time to nadir; and time to normalization of the CA125 level.
RESULTS
The CA125 level after the first chemotherapy cycle was the most significant independent prognostic factor for overall survival (OS). Time to normalization (p=0.028) and relative percentage change between CA125 levels at baseline and after the first chemotherapy cycle (p=0.021) were additional independent prognostic factors in terms of OS. The CA125 level after the first chemotherapy cycle (p=0.001) and time to normalization (p<0.001) were identified as independent prognostic factors for progression free survival (PFS).
CONCLUSION
Among well-established CA125-related prognostic factors, serum CA125 levels after the first cycle of chemotherapy and time to normalization were the most significant prognostic factors for both OS and PFS.

Keyword

CA125; ovarian cancer; prognostic factor; tumour marker

MeSH Terms

Adult
Aged
Aged, 80 and over
Antineoplastic Agents/*therapeutic use
CA-125 Antigen/*blood/metabolism
Disease-Free Survival
Female
Humans
Middle Aged
Neoplasm Staging
Neoplasms, Glandular and Epithelial/*blood/*drug therapy/mortality
Ovarian Neoplasms/*blood/*drug therapy/mortality
Prognosis
Regression Analysis
Antineoplastic Agents
CA-125 Antigen

Figure

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  Fig. 1 Kaplan-Meier survival plot for overall survival and progression free survival according to CA125 after 1st cycle of chemotherapy. CA125, cancer antigen 125.

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  Fig. 2 Kaplan-Meier survival plot for overall survival and progression free survival according to the timing of normalization of CA125. CA125, cancer antigen 125.

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