A new prognostic model for FIGO stage 1 epithelial ovarian cancer Journal Article


Authors: Obermair, A.; Fuller, A.; Lopez-Varela, E.; van Gorp, T.; Vergote, I.; Eaton, L.; Fowler, J.; Quinn, M.; Hammond, I.; Marsden, D.; Proietto, A.; Carter, J.; Davy, M.; Tripcony, L.; Abu Rustum, N.
Article Title: A new prognostic model for FIGO stage 1 epithelial ovarian cancer
Abstract: Background: No consensus exists which patients with surgical stage 1 epithelial ovarian should receive postoperative chemotherapy. The purpose of this study was to evaluate the prognostic impact of preoperative CA-125 and to establish a prognostic index to identify patients in different risk categories. Methods: Data of 600 surgically staged patients with FIGO stage 1 EOC treated in eleven gynecological cancer centers in Australia, the USA and Europe were analyzed. Eligible patients include those with invasive EOC where a preoperative CA-125 was obtained and standard surgical staging performed. Overall survival (OS) was chosen as study endpoint. Preoperative CA-125 values were compared with other prognostic factors, and univariate and multivariate Cox models were calculated. Results: Two hundred and one patients (33.5%) had preoperative CA-125 ≤ 30 U/ml and CA-125 levels ≤ 30 U/ml were associated with lower grade, substage 1A and mucinous histologic cell type. Patients with elevated CA-125 levels were more likely to receive chemotherapy. OS probability was 95% and 85% for patients with pretreatment CA-125 ≤ 30 U/ml and > 30 U/ml, respectively (p 0.003). Multivariate analysis confirmed preoperative serum CA-125 > 30 U/ml (OR 2.7) and age at diagnosis > 70 years (OR 2.6) as the only independent predictors for overall survival. Conclusion: Pretreatment of CA-125 ≤ 30 U/ml dominates over histologic cell type, substage and grade to identify a subgroup of FIGO stage 1 patients with a genuinely good prognosis with extremely good survival and who could possibly be spared with adjuvant chemotherapy. © 2007 Elsevier Inc. All rights reserved.
Keywords: adult; cancer chemotherapy; cancer survival; controlled study; human tissue; aged; middle aged; major clinical study; cisplatin; cancer risk; disease marker; chemotherapy, adjuvant; cancer staging; staging; neoplasm staging; ovarian cancer; ovarian neoplasms; protein blood level; carboplatin; antineoplastic combined chemotherapy protocols; cyclophosphamide; tumor marker; cancer invasion; ovary carcinoma; multivariate analysis; ca 125 antigen; ca-125; ca-125 antigen; cancer classification; univariate analysis
Journal Title: Gynecologic Oncology
Volume: 104
Issue: 3
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2007-03-01
Start Page: 607
End Page: 611
Language: English
DOI: 10.1016/j.ygyno.2006.09.021
PUBMED: 17092548
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 7" - "Export Date: 17 November 2011" - "CODEN: GYNOA" - "Source: Scopus"
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