Exploratory analysis of serum CA-125 response to surgery and the risk of relapse in patients with FIGO stage IIIC ovarian cancer Journal Article

   

Authors:	Zivanovic, O.; Sima, C. S.; Iasonos, A.; Bell-Mcguinn, K. M.; Sabbatini, P. J.; Leitao, M. M.; Levine, D. A.; Gardner, G. J.; Barakat, R. R.; Chi, D. S.
Article Title:	Exploratory analysis of serum CA-125 response to surgery and the risk of relapse in patients with FIGO stage IIIC ovarian cancer
Abstract:	Objective: To analyze whether serum CA-125 response to cytoreductive surgery before initiation of postoperative chemotherapy is associated with progression-free survival (PFS) in patients with stage IIIC ovarian carcinoma. Methods: We included consecutive patients with paired pre- and postoperative CA-125 measurements who underwent primary cytoreductive surgery followed by platinum-based chemotherapy between 1989 and 2006. The association of perioperative CA-125 changes with PFS was investigated using a time-to-event analysis. A Cox proportional hazards model was fit using clinical, surgical, and postoperative treatment characteristics. Results: The study included 307 evaluable patients. Overall, perioperative serum CA-125 changes were associated with PFS. The risk of disease progression increased incrementally as the magnitude of the serum CA-125 response to surgery decreased (trend test; P = 0.003). This association was pronounced in optimally but not observed in suboptimally debulked patients. After optimal cytoreduction, a perioperative increase of serum CA-125 levels was strongly associated with an increased risk of relapse compared to patients who experienced a decline of 80% or more (adjusted HR = 4.2; 95% CI: 2.04-8.66; P = 0.0001). Conclusion: Perioperative serum CA-125 changes are strongly associated with the risk of relapse in patients with optimally resected stage IIIC disease. The results of this study provide meaningful support for additional translational research correlating perioperative serum CA-125 responses of patients with molecular tumor characteristics. This may be useful for patient counseling and risk stratification during subsequent clinical trials as well as for the development of novel prognostic models. © 2009 Elsevier Inc. All rights reserved.
Keywords:	adult; aged; aged, 80 and over; disease-free survival; middle aged; major clinical study; postoperative period; cancer combination chemotherapy; cancer growth; combined modality therapy; cancer staging; antineoplastic agent; neoplasm staging; ovarian cancer; cytoreductive surgery; ovarian neoplasms; protein blood level; progression free survival; antineoplastic metal complex; antineoplastic combined chemotherapy protocols; proportional hazards models; recurrence; blood sampling; ovary carcinoma; surgery; cancer relapse; ca 125 antigen; taxane derivative; ca-125; ca-125 antigen; organoplatinum compounds; advanced epithelial ovarian cancer; perioperative serum ca-125 changes
Journal Title:	Gynecologic Oncology
Volume:	115
Issue:	2
ISSN:	0090-8258
Publisher:	Elsevier Inc.
Date Published:	2009-11-01
Start Page:	209
End Page:	214
Language:	English
DOI:	10.1016/j.ygyno.2009.06.038
PUBMED:	19664812
PROVIDER:	scopus
PMCID:	PMC3870341
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-70349756686&partnerID=40&md5=2a49d04f88c74fee9508fb2776012589
Notes:	--- - "Cited By (since 1996): 1" - "Export Date: 30 November 2010" - "CODEN: GYNOA" - "Source: Scopus"

https://synapse.mskcc.org/synapse/works/has_related_data_chk/1789