CA 125 serum levels in the early post-operative period do not reflect tumour reduction obtained by cytoreductive surgery

Yedema, C.A.; Kenemans, P.; Thomas, Chris M.G.; Massuger, L.F.A.G.; Wobbes, Th.; Verstraeten, Rob A.; Hilgers, J.; Kamp, Gerard J. van

doi:10.1016/s0959-8049(05)80203-5

Cited by 32 publications

(24 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Brand and Lidor 7 found that by using the ratio of CA-125 levels before and after cytoreductive surgery, one can predict the likelihood that the patient was left with less than 2.0 cm residual disease. Conversely, Yedema et al 9 observed that CA-125 levels in the early postoperative period (median time of 5 days) do not always reflect the outcome of cytoreduction. Preoperative CA-125 levels reflect the initial load of CA-125-secreting cells.…”

Section: Discussionmentioning

confidence: 97%

“…In fact, tumor debulking and drainage of ascites causes a fall in CA-125 levels, whereas peritoneal damage and surgical manipulation of the tumor causes an increase in antigen concentrations. 9,11,12 The latter phenomena may disrupt the effect of surgery on changing CA-125 levels. Because the natural half life of CA-125 appears to be approximately 4.8 days, 13 the CA-125 level during the immediate postoperative period seems to be influenced by other variable factors besides the reduced volume of tumor tissue.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

et al. 2008

View full text Add to dashboard Cite

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 ≥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 ≥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 ≥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.

show abstract

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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

et al. 2008

View full text Add to dashboard Cite

show abstract

“…During the follow-up, a clinical examination and CA125 measurement were performed every 3 months. The disease progression was defined as CA125 >70 U/mL confirmed twice or the presence of any new lesions in CT or 18 F-FDG-PET/CT.…”

Section: Primary Therapy and Response Evaluationmentioning

confidence: 99%

Postoperative human epididymis protein 4 predicts primary therapy outcome in advanced epithelial ovarian cancer

et al. 2017

View full text Add to dashboard Cite

Primary chemotherapy treatment response monitoring in advanced epithelial ovarian cancer (EOC) is currently based on CT-imaging and serum CA125 values. Serum HE4 profile during first line chemotherapy has not been previously studied. We evaluated the HE4 profile during first line chemotherapy after primary (PDS) and interval debulking surgery (IDS). In total, 49 FIGO stage III/IV EOC patients were included in the study. 22 patients underwent PDS and 27 patients neoadjuvant chemotherapy (NACT) followed by IDS. Serial HE4 and CA125 serum samples were taken during first line chemotherapy. The association of postoperative tumor markers to surgery outcome, primary therapy outcome and progression free survival (PFS) were determined. The lowest HE4 and CA125 values during chemotherapy were compared to primary therapy outcome and PFS. The postoperative HE4 was associated to residual tumor after surgery (p = 0.0001), primary therapy outcome (p = 0.004) and PFS (p = 0.03) in all patients (n = 40). The postoperative CA125 was associated to PFS after IDS (n = 26, p = 0.006), but not after PDS. In multivariate analysis with FIGO stage (III/IV), residual tumor (0/>0) and postoperative CA125, the postoperative HE4 was the only statistically significant prognostic variable predicting PFS. Both HE4 and CA125 nadir corresponded to primary therapy outcome (HE4 p < 0.0001, CA125 p < 0.0001) and PFS (HE4 p = 0.009, CA125 p < 0.0001). HE4 is a promising candidate for EOC response monitoring. In our study, the performance of HE4 in response monitoring of first line chemotherapy was comparable to that of CA125. Of the postoperative values, only HE4 was statistically significantly associated to primary therapy outcome.

show abstract

“…Les ré sultats sont trè s dé cevants, l'é volution du CA-125 aprè s chirurgie semblant plus influencé e par l'irritation pé ritoné ale iatrogè ne que par l'importance de la ré duction tumorale [22][23]. Dans la plupart des é tudes la concentration postopé ratoire de CA-125 n'a d'ailleurs pas de valeur pronostique [3,8] ou, lorsqu'elle en a une, celle-ci n'est pas indé pendante de la taille du reliquat tumoral postopé ratoire dont elle dé pend [21].…”

Section: Discussionunclassified

Decline of CA-125. Do we have indications and treatment guidelines?

et al. 2006

View full text Add to dashboard Cite

CA 125 serum levels in the early post-operative period do not reflect tumour reduction obtained by cytoreductive surgery

Cited by 32 publications

References 18 publications

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

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

Postoperative human epididymis protein 4 predicts primary therapy outcome in advanced epithelial ovarian cancer

Decline of CA-125. Do we have indications and treatment guidelines?

Contact Info

Product

Resources

About