Title
Author
DOI
Article Type
Special Issue
Volume
Issue
Diagnostic value of CA125 as a predictor of recurrence in advanced ovarian cancer
1Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul
2Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul (Korea)
*Corresponding Author(s): M. J. Song E-mail: bitsugar@catholic.ac.kr
Purpose: The aim of this study was to establish the guidelines for detecting early recurrences of advanced epithelial ovarian cancer by use of the CA-125 level. Materials and Methods: Eighty-five of the patients who met the inclusion criteria were enrolled in this study. The authors examined 25 incremental changes of CA125 from one to 25 IU/ml, and compared the CA-125 value with other prognostic factors. Increases in the CA-125 level from the nadir level were expressed as CA-125- increments. Results: Among the 25 increments, a CA-125-8 (eight IU/ml) was selected as the predictor that was the most efficient and time-effective. CA-125-8 had a sensitivity of 91.5%, a specificity of 84.6%, a positive predictive value of 93.1%, a negative predictive value of 81.5%, an efficiency of 89.4%. and a median lead-time of 68.5 days (p < 0.0001). Conclusion: The authors suggest the incremented CA-125-8 as a predictor of recurrent advanced ovarian cancer.
Advanced ovarian cancer, CA-125; Early detection of recurrence.
M. J. Song,S. H. Lee,M. R. Choi,H. J. Son,C. W. Lee,J. H. Yoon,Y. G. Park,S. Y. Hur,K. S. Ryu,J. M. Lee. Diagnostic value of CA125 as a predictor of recurrence in advanced ovarian cancer. European Journal of Gynaecological Oncology. 2013. 34(2);148-151.
[1] Rustin G.J., Bast R.C. Jr., Kelloff G.J., Barrett J.C., Carter S.K., Nisen P.D. et al.: “Use of CA125 in clinical trial evaluation of new therapeutic drugs for ovarian cancer”. Clin. Cancer Res., 2004, 10, 3919.
[2] Ozols R.F., Bundy B.N., Greer B.E., Fowler J.M., Clarke-Pearson D., Burger R.A. et al.: “Phase III trial of carboplatin and paclitaxel compared with cisplatin and paclitaxel in patients with optimally resected Stage III ovarian cancer: a Gynecologic Oncology Group study”. J. Clin. Oncol., 2003, 21, 3194.
[3] Mano M.S., Awada A., Minisini A., Atalay G., Lago L.D., Cardoso F. et al.: “Remaining controversies in the upfront management of advanced ovarian cancer”. Int. J. Gynecol. Cancer, 2004, 14, 707.
[4] Schorge J.O.: “From epithelial ovarian cancer: gynecologic oncology”. In: Williams Gynecology. 1st ed. Edited by Schorge J.O., Schaffer J.I., Halvorson L.M., Hoffman B.L., Bradshaw K.D. and Cunningham F.G. Dallas, TX: The McGraw-Hill Companies, Inc.; 2008, 716.
[5] Rustin G.J., van der Burg M.E., Griffin C.L., Guthrie D., Lamont A., Jayson G.C. et al.: “Early versus delayed treatment of relapsed ovarian cancer (MRC OV05/EORTC 55955): a randomised trial”. Lancet, 2010, 376, 1155.
[6] Zang R.Y., Li Z.T., Tang J., Cheng X., Cai S.M., Zhang Z.Y. et al.: “Secondary cytoreductive surgery for patients with relapsed epithelial ovarian carcinoma: who benefits?”. Cancer, 2004, 100, 1152.
[7] Chi D.S., McCaughty K., Diaz J.P., Huh J., Schwabenbauer S., Hummer A.J. et al.: “Guidelines and selection criteria for secondary cytoreductive surgery in patients with recurrent, platinum-sensitive epithelial ovarian carcinoma”. Cancer, 2006, 106, 1933.
[8] Harter P., du Bois A., Hahmann M., Hasenburg A., Burges A., Loibl S. et al.: “Surgery in recurrent ovarian cancer: The Arbeitsgemeinschaft Gynaekologische Onkologie(AGO) DESKTOPOVARTrial”. Ann. Surg. Oncol., 2006, 13, 1702.
[9] Salani R., Santillan A., Zahurak M.L., Giuntoli R.L. 2nd, Gardner G.J., Armstrong D.K. et al.: “Secondary cytoreductive surgery for localized, recurrent epithelial ovarian cancer: analysis of prognostic factors and survival outcome”. Cancer, 2007, 109, 685.
[10] Santillan A., Karam A.K., Li A.J., Giuntoli R. 2nd, Gardner G.J., Cass I. et al.: “Secondary cytoreductive surgery for isolated nodal recurrence in patients with epithelial ovarian cancer”. Gynecol. Oncol., 2007, 104, 686.
[11] Goonewardene T.I., Hall M.R., Rustin G.J.: “Management of asymptomatic patients on follow-up for ovarian cancer with rising CA125 concentrations”. Lancet Oncol., 2007, 8, 813.
[12] Tuxen M.K., Sölétormos G., Dombernowsky P.: “Serum tumor marker CA125 for monitoring ovarian cancer during follow-up”. Scand. J. Clin. Lab. Invest., 2002, 62, 177.
[13] Duffy M.J., Bonfrer J.M., Kulpa J., Rustin G.J., Soletormos G., Torre G.C. et al.: “CA125 in ovarian cancer: European group on tumor markers guidelines for clinical use”. Int. J. Gynecol. Cancer, 2005, 15, 679.
[14] Rustin G.J.: “Use of CA125 to assess response to new agents in ovarian cancer trials”. J. Clin. Oncol., 2003, 21, 187.
[15] Rustin G.J., Nelstrop A.E., Tuxen M.K., Lambert H.E.: “Defining progression of ovarian carcinoma during follow-up according to CA 125: a North Thames Ovary Group Study”. Ann. Oncol., 1996, 7, 361.
[16] Krebs H.B., Goplerud D.R., Kilpatrick S.J., Myers M.B., Hunt A.: “The role of CA 125 as tumour marker in ovarian cancer”. Obstet. Gynecol., 1986, 67, 473.
[17] Gronlund B., Lundvall L., Christensen I.J., Knudsen J.B., Høgdall C.: “Surgical cytoreduction in recurrent ovarian carcinoma in patients with complete response to paclitaxel-platinum”. Eur. J. Surg. Oncol., 2005, 31, 67.
[18] Simcock B., Neesham D., Quinn M., Drummond E., Milner A., Hicks R.J.: “The impact of PET/CT in the management of recurrent ovarian cancer”. Gynecol. Oncol., 2006, 103, 271.
[19] Crawford S.M., Peace J.: “Does the nadir CA125 concentration predict a long-term outcome after chemotherapy for carcinoma of the ovary?”. Ann. Oncol., 2005, 16, 47.
[20] Tuxen M.K., Sölétormos G., Dombernowsky P.: “Serum tumor marker CA125 in monitoring of ovarian cancer during first-line chemotherapy”. Br. J. Cancer, 2001, 84, 1301.
[21] Santillan A., Garg R., Zahurak M.L., Gardner G.J., Giuntoli R.L. 2nd, Armstrong D.K., Bristow R.E.: “Risk of epithelial ovarian cancer recurrence in patients with rising serum CA125 levels within the normal range”. J. Clin. Oncol., 2005, 23, 9338.
[22] Prat A., Parera M., Adamo B., Peralta S., Perez-Benavente M.A., Garcia A. et al.: “Risk of recurrence during follow-up for optimally treated advanced epithelial ovarian cancer (EOC) with a low-level increase of serum CA125 levels”. Ann. Oncol., 2009, 20, 294.
Top