J Gynecol Oncol.  2016 Sep;27(5):e46. 10.3802/jgo.2016.27.e46.

Comparison of survival outcomes after recurrence detected by cancer antigen 125 elevation versus imaging study in epithelial ovarian cancer

• Paik ES
• Kim TJ
• Lee YY
• Choi CH
• Lee JW
• Kim BG
• Bae DS

• KMID: 2374248
• DOI: http://doi.org/10.3802/jgo.2016.27.e46

Abstract

OBJECTIVE
The aim of this study was to compare survival outcomes in two groups of patients with recurrent epithelial ovarian cancer (EOC) with initial recurrence detection by cancer antigen 125 (CA-125) elevation or imaging, and underwent secondary cytoreductive surgery (SCS).
METHODS
A retrospective review of the medical records was performed on 99 recurrent EOC patients who underwent SCS at the Samsung Medical Center between January 2002 and December 2013. For follow-up after primary treatment, patients were routinely assessed by CA-125 levels every 3 months and computed tomography (CT) scan (or magnetic resonance imaging [MRI]) every 6 months for first 3 years, and by CA-125 every 6 months and CT scan (or MRI) every 12 months thereafter.
RESULTS
The first recurrence was initially identified by either CA-125 elevation (n=41, 41.4%) or by imaging study (n=58, 58.6%). None of the patients showed the symptoms as initial sign of recurrence. There were higher percentages of extra-pelvic recurrence (87.8%) and multiple recurrences (78.0%) in the group diagnosed by CA-125 elevation. The proportion of no residual disease after SCS was comparably lower in the CA-125 group (22.0% vs. 72.4%). There were 19 cancer-associated deaths (19.2%) within a median follow-up period of 67 months. The group diagnosed by imaging had better overall survival from initial diagnosis (OS1), overall survival after SCS (OS2), progression-free survival after the initial treatment (PFS1) and progression-free survival after SCS compared to those of the CA-125 group (PFS2).
CONCLUSION
EOC patients with recurrence initially detected by imaging study showed better survival outcomes than patients diagnosed by CA-125 elevation.

Keyword

Diagnostic Techniques and Procedures; Ovarian Neoplasms; Recurrence

MeSH Terms

Adult
Aged
CA-125 Antigen/*blood
Female
Humans
Magnetic Resonance Imaging
Middle Aged
Neoplasm Recurrence, Local/blood/diagnostic imaging/*mortality
Neoplasms, Glandular and Epithelial/blood/diagnostic imaging/*mortality
Ovarian Neoplasms/blood/diagnostic imaging/*mortality
Retrospective Studies
Tomography, X-Ray Computed
CA-125 Antigen