The ability of preoperative serum CA-125 to predict optimal primary tumor cytoreduction in stage III epithelial ovarian carcinoma Journal Article
| Authors: | Chi, D. S.; Venkatraman, E. S.; Masson, V.; Hoskins, W. J. |
| Article Title: | The ability of preoperative serum CA-125 to predict optimal primary tumor cytoreduction in stage III epithelial ovarian carcinoma |
| Abstract: | Purpose. The aim of this study was to determine the ability of preoperative serum CA-125 to predict optimal primary tumor cytoreduction in patients with Stage III epithelial ovarian carcinoma. Methods. We performed a retrospective chart review of 100 consecutive patients with Stage III ovarian carcinoma who had a serum CA-125 drawn prior to primary cytoreductive surgery. We used a receiver operating characteristic curve to determine the CA-125 level with the maximal prognostic power in predicting optimal versus suboptimal cytoreduction. Results. The median CA-125 level for the 100 patients was 819 U/ml (range 5.6-26,200 U/ml). Optimal cytoreduction (diameter of largest residual tumor nodule ≤1 cm) was obtained in 45 cases (45%). The probability of performing optimal cytoreduction decreased with increasing CA-125 levels. A preoperative CA-125 level of 500 U/ml was identified as the value with the most predictive power. Optimal cytoreduction was achieved in 33 of the 45 cases (73%) with a CA-125 less than 500 U/ml compared to only 12 of the 55 cases (22%) with a CA-125 greater than 500 U/ml. Using a threshold level of 500 U/ml, the preoperative serum CA-125 level was able to predict optimal versus suboptimal cytoreduction with a sensitivity of 78%, specificity of 73%, positive predictive value of 78%, and negative predictive value of 73%. Conclusion. The probability of performing optimal cytoreduction in patients with Stage III ovarian carcinoma and a preoperative CA-125 greater than 500 U/ml was approximately one in five. These patients may be candidates for initial laparoscopic evaluation to obtain a confirmatory tissue diagnosis and to determine resectability. (C) 2000 Academic Press. |
| Keywords: | adult; controlled study; human tissue; aged; aged, 80 and over; middle aged; cancer surgery; retrospective studies; major clinical study; cancer staging; neoplasm staging; laparoscopy; ovarian neoplasms; protein blood level; prediction; diagnostic value; antigen detection; carcinoma; ovary carcinoma; predictive value of tests; reliability; ca 125 antigen; ca-125 antigen; humans; prognosis; human; female; priority journal; article |
| Journal Title: | Gynecologic Oncology |
| Volume: | 77 |
| Issue: | 2 |
| ISSN: | 0090-8258 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2000-05-01 |
| Start Page: | 227 |
| End Page: | 231 |
| Language: | English |
| DOI: | 10.1006/gyno.2000.5749 |
| PUBMED: | 10785469 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 18 November 2015 -- Source: Scopus |
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