CA125 level as a predictor of progression-free survival and overall survival in ovarian cancer patients with surgically defined disease status prior to the initiation of intraperitoneal consolidation therapy Journal Article


Authors: Juretzka, M. M.; Barakat, R. R.; Chi, D. S.; Iasonos, A.; Dupont, J.; Abu-Rustum, N. R.; Poynor, E. A.; Aghajanian, C.; Spriggs, D.; Hensley, M. L.; Sabbatini, P.
Article Title: CA125 level as a predictor of progression-free survival and overall survival in ovarian cancer patients with surgically defined disease status prior to the initiation of intraperitoneal consolidation therapy
Abstract: Objectives: Recent data suggest that differences in CA125 levels within the normal range may predict progression-free survival (PFS), but limited information is available regarding the value of these differences in predicting overall survival (OS) in patients with epithelial ovarian cancer. The objective of this study was to determine whether CA125 is an independent predictor of OS in patients with surgically defined disease status at the end of primary therapy prior to intraperitoneal (IP) consolidation chemotherapy. A secondary objective was to assess the relationship of CA125 level to PFS. Methods: Using data from a retrospective cohort of 433 patients who received intraperitoneal (IP) therapy following primary treatment for ovarian cancer between 1984 and 1998, we identified 241 patients with a complete clinical response and CA125 data at the time of second-look surgery prior to IP chemotherapy. Patient demographics and updated follow-up status were abstracted from medical records. Kaplan-Meier survival curves were compared using the log-rank test, and Cox regression models were used for multivariate analysis. Results: The majority of patients had advanced stage III or IV disease (n = 201, 83%) and high-grade histology (n = 163, 68%). Taxane was used as part of primary platinum-based therapy in 56% (n = 134) of patients, and subsequent IP chemotherapy was platinum-based in 85% (n = 206). When considered as a continuous variable, CA125 was a predictor of OS (P = 0.029). Using the median CA125 level in our study group as a cut-off, OS was increased in patients with CA125 ≤ 12 U/ml (median 5.8 years) compared with > 12 (3.7 years) (P = 0.0027). CA125 level was an independent predictor of OS (HR: 1.410; 95% CI, 1.044, 1.904, P = 0.0248) in a multivariate model that included stage (P = 0.0166), grade (P = 0.0001), and findings at second-look surgery (P = 0.0003). CA125 level was also a predictor of clinical PFS (radiographic or CA125 elevation criteria alone) in a subset of 161 patients as a continuous variable (P = 0.0036), and when divided at the median (≤ or > 12; median 2.8 years vs. 1.7 years; P = 0.0017). Conclusions: In our study population, CA125 level at the end of primary therapy was a predictor of OS and PFS when considered as a continuous variable, or when divided at the median (≤ or > 12 U/ml). Further prospective study is required to optimize clinically significant cut-off values within the normal range of CA125 levels for both OS and PFS endpoints. © 2006 Elsevier Inc. All rights reserved.
Keywords: adult; cancer survival; treatment response; aged; disease-free survival; middle aged; cancer surgery; survival rate; retrospective studies; major clinical study; overall survival; advanced cancer; cancer combination chemotherapy; paclitaxel; cancer patient; cancer staging; follow up; neoplasm staging; cancer grading; ovarian cancer; ovarian neoplasms; ovary cancer; cohort studies; antineoplastic combined chemotherapy protocols; retrospective study; tumor marker; proportional hazards model; prognostic factors; medical record; predictive value of tests; predictor variable; multivariate analysis; platinum derivative; kaplan meier method; ca 125 antigen; taxane derivative; ca-125 antigen; second look surgery; organoplatinum compounds; ca125; infusions, parenteral; log rank test; second-look surgery
Journal Title: Gynecologic Oncology
Volume: 104
Issue: 1
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2007-01-01
Start Page: 176
End Page: 180
Language: English
DOI: 10.1016/j.ygyno.2006.07.027
PUBMED: 16996584
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 28" - "Export Date: 17 November 2011" - "CODEN: GYNOA" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Richard R Barakat
    627 Barakat
  2. Dennis S Chi
    512 Chi
  3. Elizabeth Poynor
    32 Poynor
  4. Jakob Dupont
    65 Dupont
  5. Paul J Sabbatini
    219 Sabbatini
  6. Alexia Elia Iasonos
    195 Iasonos
  7. Martee L Hensley
    233 Hensley
  8. David R Spriggs
    322 Spriggs