J Gynecol Oncol.  2008 Sep;19(3):169-172. 10.3802/jgo.2008.19.3.169.

Significance of postoperative CA-125 decline after cytoreductive surgery in stage IIIC/IV ovarian cancer

• Yoo SC
• Yoon JH
• Lyu MO
• Kim WY
• Chang SJ
• Chang KH
• Ryu HS

• KMID: 2173397
• DOI: http://doi.org/10.3802/jgo.2008.19.3.169

Abstract

OBJECTIVE
The purpose of this study was to evaluate whether the decline in serum CA-125 levels following primary cytoreductive surgery prior to starting adjuvant chemotherapy has a prognostic value in patients with stage IIIC/IV ovarian carcinoma. METHODS: A retrospective review was conducted of all patients with stage IIIC/IV ovarian carcinoma who underwent primary cytoreductive surgery followed by platinum-based chemotherapy from 1994 to 2007. Demographic, pathologic, treatment, and survival data were collected. Patients were included if serum CA-125 levels were drawn preoperatively and within one week prior to their first chemotherapy cycle, and whose postoperative CA-125 level declined. Percentage decline was calculated, and was compared with standard statistical tests in groups by 25% declination intervals. RESULTS: Of the 112 stage IIIC/IV patients, 81 (72.3%) met the above inclusion criteria. The median time from surgery to postoperative CA-125 sampling was 16 days (range: 7-42). A > or =75% decline was associated with a median progression-free survival (PFS) of 25 months (95% CI=0-63). This was significantly longer when compared with each of the other 25% interval groups. After multivariate analysis, independent prognostic factors included a > or =75% decline in CA-125 levels after surgery and the presence of residual tumor. Age, grade, histology, and preoperative CA-125 levels were not statistically significant factors. CONCLUSION: A > or =75% decline in serum CA-125 serum levels from primary cytoreductive surgery to the start of adjuvant chemotherapy has independent prognostic value for PFS in patients with stage IIIC/IV ovarian carcinoma.

Keyword

Ovarian cancer; CA-125; Survival

MeSH Terms

Chemotherapy, Adjuvant
Disease-Free Survival
Humans
Multivariate Analysis
Neoplasm, Residual
Ovarian Neoplasms
Retrospective Studies

Figure

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  Fig. 1 Progression-free survival by postoperative decline of serum CA-125.

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